Umar Hashim, Romil Patel, Hany Demo, Westby Fisher, Jose Nazari, Alex Ro, Mark Metzl, Jeremiah Wasserlauf
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引用次数: 0
Abstract
Background: Pulsed-field ablation (PFA) for atrial fibrillation (AF) offers several advantages compared to thermal ablation, however direct comparisons of patient-reported outcomes after PFA and radiofrequency ablation (RFA) are limited. This study aimed to assess patient experience following PFA or RFA in AF ablation performed under general anesthesia.
Methods: A retrospective study across a single integrated health system was conducted on consecutive patients who underwent PFA or RFA for AF under general anesthesia from March 2024 to December 2024. Data were collected from electronic medical records. Primary endpoints included postprocedural pain complaints and scores, need for postprocedure analgesic medication, and frequency of emergency department (ED) visits for procedure-related concerns.
Results: Two hundred patients (100 PFA and 100 RFA) were analyzed (age 73.2 ± 9.2 y, 38% female). Patients undergoing RFA had a significantly higher rate of ED visits compared to those who underwent PFA (17% vs. 6%, p < 0.05). The most common complaints prompting RFA ED visits were shortness of breath (29% of RFA ED visits), palpitations (23% of RFA ED visits), dizziness (18% of RFA ED visits), and other (30% of RFA ED visits). There were no statistically significant differences in postprocedural pain scores (RFA 1.70 vs. PFA 1.57, p = 0.61), requests for analgesic medications in the recovery area (RFA 36% vs. PFA 27%, p = 0.26), nor encounters made to the care team within 4 weeks following the procedure (RFA 57% vs. PFA 44%, p = 0.20).
Conclusion: In this retrospective study, patients undergoing PFA for AF under general anesthesia experienced fewer ED visits for procedure-related issues compared to those undergoing RFA. While these clinical endpoints potentially suggest improved procedural recovery with PFA compared to RFA, larger prospective studies using patient-reported outcome measures are warranted.
背景：与热消融相比，脉冲场消融（PFA）治疗心房颤动（AF）有几个优势，然而，PFA和射频消融（RFA）后患者报告的结果的直接比较是有限的。本研究旨在评估全麻下房颤消融患者在PFA或RFA后的体验。方法：通过单一综合卫生系统对2024年3月至2024年12月在全身麻醉下连续接受PFA或RFA治疗房颤的患者进行回顾性研究。数据是从电子病历中收集的。主要终点包括术后疼痛主诉和评分，术后镇痛药物的需求，以及因手术相关问题就诊的急诊科（ED）频率。结果：共分析200例患者（PFA和RFA各100例），年龄73.2±9.2岁，女性38%。与接受PFA的患者相比，接受RFA的患者ED就诊率明显更高（17% vs. 6%）。结论：在这项回顾性研究中，与接受RFA的患者相比，全麻下接受PFA治疗AF的患者因手术相关问题就诊的次数较少。虽然这些临床终点可能表明与RFA相比，PFA可以改善手术恢复，但使用患者报告的结果测量的更大的前瞻性研究是有必要的。
期刊介绍：
Journal of Cardiovascular Electrophysiology (JCE) keeps its readership well informed of the latest developments in the study and management of arrhythmic disorders. Edited by Bradley P. Knight, M.D., and a distinguished international editorial board, JCE is the leading journal devoted to the study of the electrophysiology of the heart.
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