Kryoballon ile Tek Merkezde Atriyal Fibrilasyon Ablasyonu Deneyimi

Abstract

Giriş: Pulmoner venlerin elektriksel izolasyonu, atriyal fibrilasyonun (AF) invaziv tedavisinin temel taşı olarak bilinir ve bu nedenle, AF ablasyonunda ilk adım olarak önerilmiştir. Bu çalışmada, persistant ve paroksismal AF tanısı koyulan hastalarda pulmoner ven izolasyonu (PVI) deneyimimizi ve klinik sonuçlarımızı analiz ettik. Metodoloji: Antiaritmik tedaviye dirençli semptomatik AF'si olan ardışık yüz altı hastaya pulmoner venlerin izolasyonu için kriyoablasyon uygulandı. Hastalar AF sınıflamasına göre persistant veya paroksismal olmak üzere iki gruba ayrıldı. Rekürrens ve peri-prosedürel komplikasyonlar sırasıyla birincil ve ikincil sonuçlar olarak analiz edildi. Bulgular: Yaş ortalaması 51.8 ±13.1 yıl, 67’si erkek (%63.2) olan 106 hastaya kriyoablasyon tedavisi uygulandı. 90 hastada paroksismal AF (%84.9) ve 16 hastada persistant AF (%15.1) vardı. Ortalama işlem süresi 115,9±9,1 dakika ve ortalama floroskopi süresi 29,2±5,6 dakikaydı. Ölümcül olmayan 8 (%7.5) komplikasyon gözlendi. İşlem sonrası 3 aylık dönem çıkarıldığında ortalama 25.2 aylık takip süresinde 18 nüks (%17) gözlendi. Paroksismal ve persistan gruplarda AF'nin nükssüz oranları sırasıyla %85.6 ve %61.8’idi. Sonuç: Kriyobalon ile pulmoner ven izolasyonu AF tedavisinde başarılı ve güvenilir bir yöntem olarak görünmektedir. Sonuçlarımız, kriyoablasyonun persistant AF'si olan hastalarda bile başlangıç tekniği olarak kullanılabileceğini gösteren önceki çalışmalarla uyumludur.

Keywords

• Atriyal fibrilasyon
• Kryoballoon
• Frenik sinir paralizisi

A Single Center Experience of Atrial Fibrillation Ablation with Cryoballon

Abstract

Background: Electrical isolation of the pulmonary veins is known as the fundamental of for atrial fibrillation (AF) treatment invasively, and thus, has been suggested as the first-line therapy in AF curation. In this study, we presented our single center pulmonary vein isolation (PVI) experience and long-term clinical outcome. Methods: One hundred and six symptomatic AF patients resistant to medical therapy underwent cryoablation of the pulmonary veins. Participants were divided into two groups regarding AF categorization as persistent or paroxysmal. Recurrence and peri-procedural complications were evaluated after the treatment. Results: A 106 patients, 67 males (63.2%), with mean age of 51.8 ±13.1 years, underwent cryoablation. While the paroxysmal AF group was composed of 90 patients (84.9%); the persistent AF group consisted of 16 patients (15.1%). The procedure mean time was 115,9±9,1 minute while the fluoroscopy mean time was 29,2±5,6 minutes. A total of 8 (7.5%) non-fatal complications were experienced. A total of 18 recurrences (17%) were observed during mean duration of 25.2 months follow-up period. The survival rates without AF were 85.6% and 61.8 % in in the paroxysmal and persistent groups, respectively. Conclusion: The cryoballoon PVI seems to be a successful and reliable method of treating AF and may be preferred as a primary procedure even in patients with persistent AF.

Keywords

• Atrial fibrillation
• Cryoballon
• Phrenic nerve palsy

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