Updated Worldwide Survey on the Methods, Efficacy, and Safety of Catheter Ablation for Human Atrial Fibrillation
Updated Worldwide Survey on the Methods, Efficacy, and Safety of Catheter Ablation for Human Atrial Fibrillation
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DOI：
10.1161/circep.109.859116
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发表时间：
2010-02-01
影响因子：
8.4
通讯作者：
Biganzoli, Elia
中科院分区：
文献类型：
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作者：
Cappato, Riccardo;Calkins, Hugh;Biganzoli, Elia
背景-本研究的目的是提供一份关于心房颤动（AF）导管消融的方法、疗效和安全性的最新全球报告。方法和结果-一份包含46个问题的问卷被发送到来自4大洲24个国家的521个中心。从182个中心收集了完整的访谈，其中85个中心报告在2003年至2006年期间对16309名AF患者进行了20825次导管消融术。每家临床试验机构的中位手术数量为245例（范围：2 - 2715）。所有中心均包括阵发性AF，85.9%还包括持续性AF，47.1%还包括长期AF。Carto引导的左心房环形消融（48.2%的患者）和Lasso引导的开口电切断（27.4%）是最常用的技术。使用代表分析单位的中心分析疗效数据。在16309例完全披露结局数据的患者中，10488例（中位数，70.0%;四分位数范围，57.7%至75.4%）在未使用抗肿瘤药物的情况下无症状，另有2047例患者（中位数，70.0%;四分位数范围，57.7%至75.4%）（10.0%; 0.5%至17.1%）在18个月（范围，3至24个月）的随访中，在使用之前无效的抗心律失常药物的情况下变得无症状。9590例阵发性房颤患者的免抗心律失常药物治疗成功率和总成功率（74.9%和83.2%）显著高于2800例持续性房颤患者（64.8%和75.0%）和1108例持久性房颤患者（63.1%和72.3%）（P
Background-The purpose of this study was to provide an updated worldwide report on the methods, efficacy, and safety of catheter ablation of atrial fibrillation (AF).Methods and Results-A questionnaire with 46 questions was sent to 521 centers from 24 countries in 4 continents. Complete interviews were collected from 182 centers, of which 85 reported to have performed 20 825 catheter ablation procedures on 16 309 patients with AF between 2003 and 2006. The median number of procedures per center was 245 (range, 2 to 2715). All centers included paroxysmal AF, 85.9% also included persistent and 47.1% also included long-lasting AF. Carto-guided left atrial circumferential ablation (48.2% of patients) and Lasso-guided ostial electric disconnection (27.4%) were the most commonly used techniques. Efficacy data were analyzed with centers representing the unit of analysis. Of 16 309 patients with full disclosure of outcome data, 10 488 (median, 70.0%; interquartile range, 57.7% to 75.4%) became asymptomatic without antiarrhythmic drugs and another 2047 (10.0%; 0.5% to 17.1%) became asymptomatic in the presence of previously ineffective antiarrhythmic drugs over 18 (range, 3 to 24) months of follow-up. Success rates free of antiarrhythmic drugs and overall success rates were significantly larger in 9590 patients with paroxysmal AF (74.9% and 83.2%) than in 2800 patients with persistent AF (64.8% and 75.0%) and 1108 patients with long-lasting AF (63.1% and 72.3%) (P