Comparing cryoballoon and contact-force guided radiofrequency ablation in pulmonary vein isolation for atrial fibrillation in patients with hypertrophic cardiomyopathy.

IF 2.1 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS
Takahiko Kinjo, Masaomi Kimura, Daisuke Horiuchi, Taihei Itoh, Yuji Ishida, Kimitaka Nishizaki, Yuichi Toyama, Shogo Hamaura, Shingo Sasaki, Hirofumi Tomita
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引用次数: 0

Abstract

Background: Pulmonary vein isolation (PVI) employing cryoballoon (CB) or contact force-guided radiofrequency (CF-RF) catheter ablation has been established as an effective strategy for managing atrial fibrillation (AF). However, its efficacy in hypertrophic cardiomyopathy (HCM) remains to be further explored.

Methods: This retrospective study analyzed 60 consecutive AF patients with HCM (average age 67 ± 10 years; 41 men) who were consecutively admitted to our hospital from January 2014 to December 2022 and underwent initial PVI.

Results: The patients were treated with CB (26 patients) or CF-RF (34 patients). Successful PVI was achieved in both groups without significant complications. In the CF-RF group, additional ablations were performed on the cavotricuspid isthmus (14.7% of patients) and the anterior line (2.9%). The CB group benefited from reduced procedural times (93 ± 31 vs. 165 ± 60 min, p < 0.05) and decreased saline irrigation requirements (77.5 ± 31.4 vs. 870 ± 281.9 mL, p < 0.0001). Using a contrast medium was exclusive to the CB group (33.8 ± 4.2 mL). In a 12-month follow-up, the atrial tachyarrhythmia recurrence-free rates in the CB and CF-RF groups were comparable (77% and 76%, respectively; p = 0.63 according to the log-rank test). Notably, pulmonary vein reconnection was prevalent in most (7 out of 8) patients requiring a secondary ablation procedure.

Conclusion: PVI is feasible as a strategy for AF in patients with HCM employing either CB or CF-RF techniques. While the recurrence-free rates were comparable in both groups, differences were noted in procedure duration, saline usage, and the need for a contrast medium.

Abstract Image

比较冷冻球囊和接触力引导射频消融术在肥厚型心肌病患者肺静脉隔离治疗心房颤动中的应用。
背景:采用冷冻球囊(CB)或接触力引导射频(CF-RF)导管消融术进行肺静脉隔离(PVI)已被确定为治疗心房颤动(AF)的有效策略。然而,其对肥厚型心肌病(HCM)的疗效仍有待进一步探讨:这项回顾性研究分析了我院在 2014 年 1 月至 2022 年 12 月期间连续收治的 60 例 HCM 房颤患者(平均年龄 67 ± 10 岁;男性 41 例),他们都接受了初始 PVI 治疗:结果:患者接受了 CB(26 例)或 CF-RF (34 例)治疗。两组患者均成功进行了 PVI,无明显并发症。在 CF-RF 组中,对腔静脉峡部(14.7% 的患者)和前线(2.9% 的患者)进行了额外的消融术。CB 组因手术时间缩短而获益(93±31 分钟 vs. 165±60 分钟,P 结论:PVI 是一种可行的策略:采用 CB 或 CF-RF 技术作为 HCM 患者房颤的治疗策略,PVI 是可行的。虽然两组的无复发率相当,但在手术时间、生理盐水用量和造影剂需求方面存在差异。
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来源期刊
CiteScore
4.30
自引率
11.10%
发文量
320
审稿时长
4-8 weeks
期刊介绍: The Journal of Interventional Cardiac Electrophysiology is an international publication devoted to fostering research in and development of interventional techniques and therapies for the management of cardiac arrhythmias. It is designed primarily to present original research studies and scholarly scientific reviews of basic and applied science and clinical research in this field. The Journal will adopt a multidisciplinary approach to link physical, experimental, and clinical sciences as applied to the development of and practice in interventional electrophysiology. The Journal will examine techniques ranging from molecular, chemical and pharmacologic therapies to device and ablation technology. Accordingly, original research in clinical, epidemiologic and basic science arenas will be considered for publication. Applied engineering or physical science studies pertaining to interventional electrophysiology will be encouraged. The Journal is committed to providing comprehensive and detailed treatment of major interventional therapies and innovative techniques in a structured and clinically relevant manner. It is directed at clinical practitioners and investigators in the rapidly growing field of interventional electrophysiology. The editorial staff and board reflect this bias and include noted international experts in this area with a wealth of expertise in basic and clinical investigation. Peer review of all submissions, conflict of interest guidelines and periodic editorial board review of all Journal policies have been established.
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