Background Atrial fibrillation(AF)is a generally acknowledged turning-point of the natural history of hypertrophic cardiomyopathy(HCM);however,data from the cryoballoon ablation(CBA)for AF in HCM patients are relative...Background Atrial fibrillation(AF)is a generally acknowledged turning-point of the natural history of hypertrophic cardiomyopathy(HCM);however,data from the cryoballoon ablation(CBA)for AF in HCM patients are relatively scarce.The study aimed to evaluate the efficacy and safety of CBA in HCM patients with AF.Methods We retrospectively analyzed HCM patients among 1253 patients with symptomatic AF who underwent CBA for pulmonary vein isolation in a single center.The study analyzed the AF recurrence and assessed the CBA indexes,including nadir temperature,time-to-isolation,CBA failure,pulmonary vein potentials(PVPs),and redo procedure.Results A total of 108 patients were included(mean age:59.0±6.9 years),27 patients(25%)had HCM,with the median follow-up duration of 25.5 months.The one-year AF-free rates were 79.0%vs.63.0%(non-HCM vs.HCM),while the two-year AF-free rates were 77.8%vs.55.1%[hazard ratio(HR)=2.758,log-rank P=0.024].Patients with persistent AF had poor AF-free rates compared to those with paroxysmal AF(P<0.001).The CBA failure was the most common in the right inferior pulmonary veins,which had the lowest PVPs.Multivariate Cox regression analysis indicated that HCM and persistent AF were risk factors for AF recurrence(HR=2.74,95%CI:1.29–5.79,P=0.008;and HR=3.97,95%CI:1.85–8.54,P<0.001,respectively).Conclusions The CBA can be effectively and safely used to treat HCM patients with symptomatic AF.The freedom from AF for HCM patients after CBA is relatively low compared to that for non-HCM patients.展开更多
BACKGROUND Pulmonary vein isolation(PVI)alone for persistent atrial fibrillation(PersAF)remains controversial.The characteristics of cryoballoon ablation(CBA)to treat PersAF and the blanking period recurrence are unde...BACKGROUND Pulmonary vein isolation(PVI)alone for persistent atrial fibrillation(PersAF)remains controversial.The characteristics of cryoballoon ablation(CBA)to treat PersAF and the blanking period recurrence are underreported.METHODS This study retrospectively analyzed patients with PersAF undergoing second-generation CBA for de novo PVI.The post-procedural efficacy and survival analysis were compared between patients with different PersAF durations.The multivariate Cox regression analysis was used to detect the risk factors for recurrence.Early and long-term recurrence were analyzed relative to each other.RESULTS A total of 329 patients were enrolled,with a median PersAF duration of 4.0 months(interquartile range:2.0–12.0 months);257 patients(78.1%)were male.Kaplan-Meier analysis of freedom from atrial fibrillation recurrence at 12,24,and 30 months showed 71.0%,58.5%,and 54.9%,respectively.Early PersAF had a relatively favorable survival rate and a narrow P-wave duration of restoring sinus rhythm compared with that of PersAF lasting more than three months(P<0.05).The multivariate Cox regression analysis revealed that PersAF duration and left atrial anteroposterior diameter≥42 mm were the risk factors for atrial fibrillation recurrence after CBA[hazard ratio(HR)=1.89,95%CI:1.01–1.4,P=0.042;HR=3.6,95%CI:2.4–5.4,P<0.001,respectively].The blanking period recurrence predicted the long-term recurrence(P<0.0001).CONCLUSIONS CBA of PersAF had safety and efficacy to reach de novo PVI.The PersAF duration and left atrial size were risk factors for atrial fibrillation recurrence after CBA.Blanking period recurrence was associated with long-term recurrence.展开更多
基金supported by the National Natural Science Foundation of China(No.81670309)。
文摘Background Atrial fibrillation(AF)is a generally acknowledged turning-point of the natural history of hypertrophic cardiomyopathy(HCM);however,data from the cryoballoon ablation(CBA)for AF in HCM patients are relatively scarce.The study aimed to evaluate the efficacy and safety of CBA in HCM patients with AF.Methods We retrospectively analyzed HCM patients among 1253 patients with symptomatic AF who underwent CBA for pulmonary vein isolation in a single center.The study analyzed the AF recurrence and assessed the CBA indexes,including nadir temperature,time-to-isolation,CBA failure,pulmonary vein potentials(PVPs),and redo procedure.Results A total of 108 patients were included(mean age:59.0±6.9 years),27 patients(25%)had HCM,with the median follow-up duration of 25.5 months.The one-year AF-free rates were 79.0%vs.63.0%(non-HCM vs.HCM),while the two-year AF-free rates were 77.8%vs.55.1%[hazard ratio(HR)=2.758,log-rank P=0.024].Patients with persistent AF had poor AF-free rates compared to those with paroxysmal AF(P<0.001).The CBA failure was the most common in the right inferior pulmonary veins,which had the lowest PVPs.Multivariate Cox regression analysis indicated that HCM and persistent AF were risk factors for AF recurrence(HR=2.74,95%CI:1.29–5.79,P=0.008;and HR=3.97,95%CI:1.85–8.54,P<0.001,respectively).Conclusions The CBA can be effectively and safely used to treat HCM patients with symptomatic AF.The freedom from AF for HCM patients after CBA is relatively low compared to that for non-HCM patients.
基金supported by the National Natural Science Foundation of China(No.81670309).
文摘BACKGROUND Pulmonary vein isolation(PVI)alone for persistent atrial fibrillation(PersAF)remains controversial.The characteristics of cryoballoon ablation(CBA)to treat PersAF and the blanking period recurrence are underreported.METHODS This study retrospectively analyzed patients with PersAF undergoing second-generation CBA for de novo PVI.The post-procedural efficacy and survival analysis were compared between patients with different PersAF durations.The multivariate Cox regression analysis was used to detect the risk factors for recurrence.Early and long-term recurrence were analyzed relative to each other.RESULTS A total of 329 patients were enrolled,with a median PersAF duration of 4.0 months(interquartile range:2.0–12.0 months);257 patients(78.1%)were male.Kaplan-Meier analysis of freedom from atrial fibrillation recurrence at 12,24,and 30 months showed 71.0%,58.5%,and 54.9%,respectively.Early PersAF had a relatively favorable survival rate and a narrow P-wave duration of restoring sinus rhythm compared with that of PersAF lasting more than three months(P<0.05).The multivariate Cox regression analysis revealed that PersAF duration and left atrial anteroposterior diameter≥42 mm were the risk factors for atrial fibrillation recurrence after CBA[hazard ratio(HR)=1.89,95%CI:1.01–1.4,P=0.042;HR=3.6,95%CI:2.4–5.4,P<0.001,respectively].The blanking period recurrence predicted the long-term recurrence(P<0.0001).CONCLUSIONS CBA of PersAF had safety and efficacy to reach de novo PVI.The PersAF duration and left atrial size were risk factors for atrial fibrillation recurrence after CBA.Blanking period recurrence was associated with long-term recurrence.
