Impact of Stable Coronary Artery Disease on the Efficacy of Cryoballoon Ablation for the Atrial Fibrillation
Impact of Stable Coronary Artery Disease on the Efficacy of Cryoballoon Ablation for the Atrial Fibrillation
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稳定型冠状动脉疾病对冷冻球囊消融治疗心房颤动疗效的影响
DOI：
10.1016/j.amjms.2019.06.004
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发表时间：
2019-09-01
影响因子：
3.1
通讯作者：
Xu, Yawei
中科院分区：
文献类型：
--
作者：
Liu, Lu;Zhao, Dongdong;Xu, Yawei
背景：冷冻机消融已成为治疗无冠状动脉疾病的房颤的有效策略。房颤通常与CAD相结合。然而，冠心病对房颤患者冷冻消融结果的影响尚不清楚。本研究的目的是探讨稳定的冠心病对冷冻消融治疗房颤疗效的影响。材料和方法：连续收集384例接受冷凝治疗的房颤患者的资料。将患者分为冠心病组和非冠心病组。所有患者于冷冻消融后1、3、6、12个月在门诊进行定期随访，以评估房颤复发情况。结果：74例(19.3%)患者存在稳定的冠心病，其中31例(8.1%)在冷冻消融前接受了经皮冠状动脉介入治疗。冷冻消融1521条肺静脉，肺静脉隔离率达99.1%。354例获得成功随访，平均随访12+/-6个月，其中280例(79.1%)维持稳定的窦性心律，74例(20.9%)房颤复发。冠心病组与非冠心病组房颤复发率分别为16.4%和22.0%，差异无统计学意义(P>0.05)。冠心病的存在、部位和严重程度与冷冻消融后房颤复发无关，持续性房颤、N末端脑利钠肽原和左房内径是房颤复发的独立预测因素。结论：冷冻消融治疗稳定性冠心病患者房颤是有效的。冠心病的存在对冷冻消融后的房颤复发没有影响。
Background: Cryoballoon ablation has become an effective strategy for the treatment of atrial fibrillation (AF) without coronary artery disease (CAD). AF is usually coupled with CAD. However, the impact of CAD on the outcome of cryoablation in AF patients remains unclear. The objective of our study was to investigate the impact of stable CAD on the efficacy of cryoballoon ablation for AF.Materials and Methods: The data of 384 patients who underwent AF cryoablation were consecutively collected. Patients were classified into a CAD group and a non-CAD group. All patients were listed for a scheduled follow-up visit in the outpatient clinics to evaluate the AF recurrence at 1, 3, 6 and 12 months after cryoablation.Results: Seventy-four patients (19.3%) suffered from stable CAD, and 31 (8.1%) of them underwent PCI before cryoablation. Cryoablation was performed in 1521 pulmonary veins and 99.1% of pulmonary vein isolation was achieved. Successful follow-up was obtained in 354 patients after a mean of 12 +/- 6 months, in which 280 patients (79.1%) had maintained stable sinus rhythm, and 74 patients (20.9%) had AF recurrence. There was no significant difference in AF recurrence between patients with and without CAD (16.4% versus 22.0%). Furthermore, the presence, location and severity of CAD were not associated with AF recurrence after cryoablation while persistent AF, N-terminal pro-brain natriuretic peptide and left atrial diameter served as independent predictors of AF recurrence.Conclusions: Cryoballoon ablation is effective for the treatment of AF in stable CAD patients. The presence of CAD has no impact on the AF recurrence after cryoablation.