Bonus-freeze: benefit or risk? Two-year outcome and procedural comparison of a "bonus-freeze" and "no bonus-freeze" protocol using the second-generation cryoballoon for pulmonary vein isolation.
Bonus-freeze: benefit or risk? Two-year outcome and procedural comparison of a "bonus-freeze" and "no bonus-freeze" protocol using the second-generation cryoballoon for pulmonary vein isolation.
复制标题
DOI：
10.1007/s00392-016-0987-8
复制
发表时间：
2016-09
期刊：
影响因子：
--
通讯作者：
Metzner A
中科院分区：
文献类型：
--
作者：
Heeger CH;Wissner E;Wohlmuth P;Mathew S;Hayashi K;Sohns C;Reißmann B;Lemes C;Maurer T;Saguner AM;Santoro F;Riedl J;Ouyang F;Kuck KH;Metzner A
第二代低温球囊为基础的肺静脉隔离显示了令人鼓舞的急性和中期临床结果。通常，在成功隔离肺静脉后进行额外冻结。比较奖励冻结方案和不奖励冻结方案的长期临床结果和安全性。共有120例连续发作性房颤[95/120(79%)]或持续性房颤[25/120(21%)]患者接受了基于cb2的PVI。冻结周期为240 s。在前60例患者中，PVI成功后进行了额外冻结（第一组），而在随后的60例患者中，不进行额外冻结（第二组）。2组手术时间和透视时间明显缩短[113.8±32 vs 138.2±29 min （p = 0.03）和19.2±6 vs 24.3±8 min (p = 0.02)]。手术并发症无明显差异。在平均849±74天（1组）和848±101天（2组，p = 0.13）随访期间，69%的患者（1组）和67%的患者（2组）保持稳定的窦性心律，两组间无差异（p = 0.69）。第二代低温球囊肺静脉隔离后房颤的缓解和随访时间2年，采用加冻方案和不加冻方案时是相当的，而不加冻方案的手术和透视时间明显缩短。围手术期并发症无差异。
Second-generation cryoballoon based pulmonary vein isolation has demonstrated encouraging acute and mid-term clinical outcome. Customarily, a bonus-freeze is applied after successful pulmonary vein isolation. To compare the long-term clinical outcome and safety profile of a bonus-freeze and a no bonus-freeze protocol. A total of 120 consecutive patients with paroxysmal [95/120 (79 %)] or persistent atrial fibrillation [25/120 (21 %)] underwent CB2-based PVI. Freeze-cycle duration was 240 s. In the first 60 patients a bonus-freeze was applied after successful PVI (group 1), while in the following 60 patients the bonus-freeze was omitted (group 2). Procedure and fluoroscopy times were significantly shorter in group 2 [113.8 ± 32 vs 138.2 ± 29 min (p = 0.03) and 19.2 ± 6 vs 24.3 ± 8 min (p = 0.02)]. No differences in procedural complications were found. During a mean follow-up of 849 ± 74 (group 1) and 848 ± 101 days (group 2, p = 0.13) 69 % of patients (group 1) and 67 % of patients (group 2) remained in stable sinus rhythm without any differences between the groups (p = 0.69). Freedom from atrial fibrillation after second-generation cryoballoon based pulmonary vein isolation and a follow-up of >2 years is comparable when applying a bonus- and a no bonus-freeze protocol, while procedure and fluoroscopy times are significantly shorter when omitting the bonus-freeze. No differences in periprocedural complications were identified.