会聚手术治疗心力衰竭伴射血分数降低的长期持续性心房颤动。

IF 2.3 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Archives of Cardiovascular Diseases Pub Date : 2025-02-01 DOI:10.1016/j.acvd.2024.10.333
Frédéric A. Sebag , Konstantinos Zannis , Manel Miled , Justine Durand , Pierre Jorrot , Olivier Villejoubert , Nicolas Mignot , Jean-Marc Darondel , Baptiste Courty , Edouard Simeon , Eric Bergoend , Randall Lee , Nicolas Lellouche
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引用次数: 0

摘要

背景:导管消融治疗心力衰竭伴射血分数降低的心房颤动患者可显著降低病死率。会聚过程是治疗长期持续性心房颤动的有效消融选择。目的:描述心力衰竭伴射血分数降低和长期持续性心房颤动患者行会聚手术的结果。方法:我们研究了2009年至2020年间两个法国中心的连续患者。主要终点是术后3、6和12个月通过24小时动态心电图评估无房性心律失常。术前和术后1年通过经胸超声心动图评估左心室射血分数。所有患者至少有12个月的随访。结果:纳入43例患者(86%为男性)。基线左室射血分数为38±10.5%,指标左房容积为50±27mL/m2。在研究人群中,34名患者(79%)在随访结束时无房颤/心动过速。未发生手术期间死亡。我们观察到2例腹股沟血肿和4例轻度心包积液。在12个月的随访中,21例患者(49%)仍在接受抗心律失常药物治疗,10例患者(23%)的抗心律失常药物剂量减少。12个月时左室射血分数的绝对中位改善率为8% (P=0.003)。结论:对于心力衰竭伴射血分数降低和长期持续性心房颤动的患者,收敛手术已被证明是有效和安全的,并能显著改善左心室功能。
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Convergent procedure for long-standing persistent atrial fibrillation in heart failure with reduced ejection fraction

Background

Catheter ablation for atrial fibrillation in patients with heart failure with reduced ejection fraction is associated with a significant reduction in morbimortality. The convergent procedure is a valid ablation option for the treatment of long-standing persistent atrial fibrillation.

Aim

To describe the outcomes of patients with heart failure with reduced ejection fraction and long-standing persistent atrial fibrillation who underwent the convergent procedure.

Methods

We studied consecutive patients included in two French centres between 2009 and 2020. Primary endpoint was freedom from any atrial arrhythmia assessed on 24-hour Holter electrocardiogram at 3, 6 and 12 months after the procedure. Left ventricular ejection fraction was assessed on transthoracic echocardiography before and 1 year after the procedure. All patients had at least 12 months of follow-up.

Results

Forty-three patients were included (86% were men). Baseline left ventricular ejection fraction was 38 ± 10.5% and indexed left atrial volume was 50 ± 27 mL/m2. Among the study population, 34 patients (79%) were free from atrial fibrillation/tachycardia at the end of follow-up. No periprocedural death occurred. We observed two groin haematomas and four mild pericardial effusions. At 12-month follow-up, 21 patients (49%) were still on antiarrhythmic drug therapy, and a reduction in antiarrhythmic drug dosage was achieved in 10 patients (23%). The absolute median improvement in left ventricular ejection fraction was 8% at 12 months (P = 0.003).

Conclusions

The convergent procedure has been shown to be effective and safe for patients with patients with heart failure with reduced ejection fraction and long-standing persistent atrial fibrillation, with significant left ventricular function improvement.
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来源期刊
Archives of Cardiovascular Diseases
Archives of Cardiovascular Diseases 医学-心血管系统
CiteScore
4.40
自引率
6.70%
发文量
87
审稿时长
34 days
期刊介绍: The Journal publishes original peer-reviewed clinical and research articles, epidemiological studies, new methodological clinical approaches, review articles and editorials. Topics covered include coronary artery and valve diseases, interventional and pediatric cardiology, cardiovascular surgery, cardiomyopathy and heart failure, arrhythmias and stimulation, cardiovascular imaging, vascular medicine and hypertension, epidemiology and risk factors, and large multicenter studies. Archives of Cardiovascular Diseases also publishes abstracts of papers presented at the annual sessions of the Journées Européennes de la Société Française de Cardiologie and the guidelines edited by the French Society of Cardiology.
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