低温球囊肺静脉分离至大肺静脉的非闭塞性分离冷冻。

IF 1.3
Pacing and clinical electrophysiology : PACE Pub Date : 2025-09-01 Epub Date: 2025-08-02 DOI:10.1111/pace.70025
Hirofumi Arai, Yuichiro Sagawa, Takatoshi Shigeta, Kazuya Murata, Koji Sudo, Yumi Yasui, Atsuhito Oda, Manabu Kurabayashi, Kaoru Okishige, Tetsuo Sasano, Yasuteru Yamauchi
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引用次数: 0

摘要

背景:低温球囊肺静脉(PV)隔离(PVI)需要PV闭塞,这对大PV具有挑战性。在这些情况下,非闭塞性单独冻结,包括冻结PV口的上下部分而不完全闭塞,通常是有用的。本研究旨在评估非闭塞分离冷冻技术的疗效和长期结果,并比较POLARx和Arctic Front Advance Pro (AFA-Pro)的治疗细节。方法:对我院2019年9月至2023年4月行低温球囊PVI非闭塞单独冷冻的患者进行分析,随访1年。比较了POLARx和AFA-Pro非闭塞性单独冷冻治疗PVI的成功率和治疗效果。1年无心律失常生存率也进行了评估。结果:总共分析了135个pv (POLARx, n = 63;AFA-Pro, n = 72)。PVI的成功率分别为55/63(87.3%)和52/72 (72.2%),p = 0.04。POLARx和AFA-Pro的最低温度分别为-52.2±4.7°C和-42.4±7.4°C, p < 0.001。两组均未见膈神经损伤,但有2例胃动力低下。POLARx和AFA-Pro的1年无心律失常生存率分别为86.4%和81.2%,p = 0.47。结论:使用非闭塞性分离冷冻技术进行PVI的成功率约为80%,使用POLARx的成功率明显高于AFA-Pro。两组1年无心律失常生存率差异无统计学意义。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Non-Occlusive Separate Freezing for Cryoballoon Pulmonary Vein Isolation to the Large Pulmonary Vein.

Background: Cryoballoon pulmonary vein (PV) isolation (PVI) requires PV occlusion, which can be challenging to the large PV. The non-occlusive separate freezing, which involves freezing the superior and inferior portions of the PV ostium without complete occlusion, is often useful in these situations. This study aimed to evaluate the efficacy and long-term results of the non-occlusive separate freezing technique and compare the treatment details of POLARx and Arctic Front Advance Pro (AFA-Pro).

Methods: Patients who underwent cryoballoon PVI using the non-occlusive separate freezing between September 2019 and April 2023 in our institution were analyzed and followed up for 1 year. Success rates of PVI by non-occlusive separate freezing and treatment outcomes were compared between POLARx and AFA-Pro. The 1-year arrhythmia-free survival was also evaluated.

Results: Overall, 135 PVs were analyzed (POLARx, n = 63; and AFA-Pro, n = 72). The success rates of PVI for the POLARx and AFA-Pro were 55/63 (87.3%) and 52/72 (72.2%), p = 0.04. The nadir temperatures for the POLARx and AFA-Pro were -52.2 ± 4.7°C and -42.4 ± 7.4°C, p < 0.001. No phrenic nerve injury occurred in either group, but two cases of gastric hypomotility were observed using POLARx. The 1-year arrhythmia-free survival rates for POLARx and AFA-Pro were 86.4% and 81.2%, p = 0.47.

Conclusions: The success rate of PVI using the non-occlusive separate freezing technique was approximately 80% and was significantly higher with POLARx than with AFA-Pro. The 1-year arrhythmia-free survival rate was not significantly different.

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