Minimally invasive surgical versus catheter ablation for the long-lasting persistent atrial fibrillation.
Minimally invasive surgical versus catheter ablation for the long-lasting persistent atrial fibrillation.
复制标题
微创手术与导管消融治疗长期持续性心房颤动
DOI：
10.1371/journal.pone.0022122
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发表时间：
2011
期刊：
影响因子：
3.7
通讯作者：
Meng X
中科院分区：
文献类型：
--
作者：
Wang J;Li Y;Shi J;Han J;Xu C;Ma C;Meng X
目的评价电视辅助微创手术与导管消融术治疗长期持续性房颤的疗效。方法回顾性分析2006年至2009年166例长期持续性房颤患者，其中电视辅助微创消融术83例，导管消融术83例。使用“配对病例对照”方法筛选导管组，以便从169例可能适合手术但已接受导管方法治疗的长期持续性AF患者中选择适当的统计学比较候选人，以平衡两组之间的主要预后因素。所有患者的随访时间为1 - 3.6年。结果无手术死亡。手术组1例患者发生卒中，但在出院前恢复。随访期间，导管组和手术组的无房颤率分别为59.0%和74.7%（P = 0.047）。 导管组患者的心律失常复发率显著高于手术治疗组（P=0.011，风险比：0.555，95% CI：0.354 - 0.872）。 导管组和手术组的无抗肿瘤药物率分别为44.6%和61.4%（P = 0.043）。 结论回顾性对比研究中，电视微创消融术安全有效，对长期持续性房颤患者的成功率乐观。因此，进一步的随机研究解决这个问题似乎是合理的。
Objective To assess the efficacy of video-assisted minimally invasive surgical vs. catheter ablation for the long-standing persistent AF. Methods We performed a retrospective comparative analysis in a series of 166 long-standing persistent AF patients treated between 2006 and 2009 with either video-assisted minimally invasive ablation (83 patients), or catheter ablations (83 patients). The catheter group was screened using a ‘pair-matched case-control’ methodology in order to select appropriate statistical comparison candidates out of 169 long-standing persistent AF patients which were potentially suitable for surgery, but have been treated with catheter approaches in order to balance major prognostic factors between the two groups. Follow-up for all patients ranged from 1 to 3.6 years. Results No patient died postoperatively. One patient suffered from stroke in the surgical group but recovered before discharge. Freedom from AF was obtained in 59.0% and 74.7% during follow-up in the catheter group and the surgical group respectively (P = 0.047). Patients in the catheter group had a significantly higher rate of recurrent arrhythmia (P = 0.011, hazard ratio: 0.555, 95% CI: 0.354 to 0.872) compared with the surgically treated group. The freedom from antiarrhythmic drugs was 44.6% in the catheter group and 61.4% in the surgical group (P = 0.043). Conclusions The video-assisted minimally invasive ablation was safe and effective, and had an optimistic success rate for patients with long-standing persistent AF in our retrospective comparative study. Thus, further randomized studies addressing this issue seem to be justified.
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发表时间：
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