Comparisons of different radiofrequency ablation approaches for persistent atrial fibrillation:atrial fibrillation clinical trial in China
会议名称：《中华医学会心电生理和起搏分会第十次全国学术年会》
会议日期：2012年
学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学]
摘 要：Objective Several techniques based on circumferential pulmonary vein isolation(CPVI) have been successfully used in persistent atrial fibrillation(AF),but have not been adequately compared. Methods and Results This study included 315 patients registered in the Atrial Fibrillation Clinical Trial(AFCT) in *** patients had persistent AF and received CPVI,CPVI plus linear lesion(LL), or CPVI combined with ablation of complex fragmented atrial electrograms(CFAEs).Follow-up was conducted at 3,6 and 12 months after *** three protocols did not differ in efficacy at 3 months. At the 1-year follow-up,however,CPVI was inferior to CPVI + LL or CPVI + CFAEs(62.5%sinus rhythm vs.75.6%and 73.8%).CPVI + LL and CPVI + CFAEs were comparable to each *** three treatments increased left ventricle ejection fraction(EF),but did not affect left atrial diameter(LAD) or left ventricular end diastolic diameter(LVEDD).LL and ablation of CFAEs increased the total time of the procedure and the time of radiofrequency applications,but did not increase the time of *** patient in the CPVI arm had cardiac tamponade after ablation;there were no severe complications in any of the other groups. Conclusions CPVI combined with LL or CFAEs is superior to CPVI alone in maintaining sinus rhythm and is comparable in safety profile,but the benefits taked more than 6 months to *** significant difference can be detected between CPVI + LL and CPVI + CFAEs for at least 1 year after follow-up.