Worldwide survey on the methods, efficacy, and safety of catheter ablation for human atrial fibrillation
Worldwide survey on the methods, efficacy, and safety of catheter ablation for human atrial fibrillation
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DOI：
10.1161/01.cir.0000157153.30978.67
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发表时间：
2005-03-08
期刊：
影响因子：
37.8
通讯作者：
Skanes, A
中科院分区：
文献类型：
--
作者：
Cappato, R;Calkins, H;Skanes, A
背景-本研究的目的是进行一项全球调查，调查心房颤动（AF）导管消融（CA）的方法、疗效和安全性。方法和结果-向全球777个中心发送了一份详细的问卷。与研究目的相关的数据收集自181家中心，其中100家在1995年至2002年期间正在进行房颤CA项目。接受这一手术的病人人数从1995年的18人增加到2002年的5 050人。每家临床试验机构的中位手术次数为37.5（范围：1 - 600）。阵发性AF、持续性AF和永久性AF分别是100.0%、53.0%和20.0%的响应中心的指示性心律失常。最常用的技术是1995年至1997年的右心房房室化，1998年至1999年的触发灶消融，以及2000年至2002年的多条肺静脉电切断。在90家中心完成CA方案的8745例患者中，（27.3%）需要> 1次手术，4550例（52.0%;中心间范围，14.5%至76.5%）在未使用药物的情况下无症状，另外2094例（23.9%;各中心范围，8.8%至50.3%）在11.6 +/- 7.7个月随访期内，在既往无效的抗肿瘤药物存在下无症状。在524例患者（6.0%）中报告了至少1例主要并发症（6.0%）。结论-本调查的结果提供了一个图片的变量和不断发展的方法，有效性和安全性的CA AF实践中，在世界各地的大量中心，并可能作为一个指南，临床医生考虑治疗方案的患者患有这种心律失常。
Background - The purpose of this study was to conduct a worldwide survey investigating the methods, efficacy, and safety of catheter ablation (CA) of atrial fibrillation (AF).Methods and Results - A detailed questionnaire was sent to 777 centers worldwide. Data relevant to the study purpose were collected from 181 centers, of which 100 had ongoing programs on CA of AF between 1995 and 2002. The number of patients undergoing this procedure increased from 18 in 1995 to 5050 in 2002. The median number of procedures per center was 37.5 (range, 1 to 600). Paroxysmal AF, persistent AF, and permanent AF were the indicated arrhythmias in 100.0 %, 53.0 %, and 20.0 % of responding centers, respectively. The most commonly used techniques were right atrial compartmentalization between 1995 and 1997, ablation of the triggering focus in 1998 and 1999, and electrical disconnection of multiple pulmonary veins between 2000 and 2002. Of 8745 patients completing the CA protocol in 90 centers, of whom 2389 (27.3 %) required > 1 procedure, 4550 (52.0 %; range among centers, 14.5 % to 76.5 %) became asymptomatic without drugs and another 2094 (23.9 %; range among centers, 8.8 % to 50.3 %) became asymptomatic in the presence of formerly ineffective antiarrhythmic drugs over an 11.6 +/- 7.7-month follow-up period. At least 1 major complication was reported in 524 patients (6.0 %).Conclusions - The findings of this survey provide a picture of the variable and evolving methods, efficacy, and safety of CA for AF as practiced in a large number of centers worldwide and may serve as a guide to clinicians considering therapeutic options in patients suffering from this arrhythmia.