冷冻球囊与射频消融对心房颤动患者心肌损伤程度的比较

目的通过比较冷冻球囊与射频消融术对心房颤动(简称房颤)患者心肌损伤程度的差异,探讨其对术后房颤急性期复发率的影响。方法 45例房颤患者按照消融术式的不同分为两组:射频组(n=20)与冷冻组(n=25)。于术前、术后6~12h内及术后3~5d内对患者抽血检测肌钙蛋白I(cTnI)水平,并在术后3~5d内行24h动态心电图检查。结果 (1)与术前相比,射频组与冷冻组两组术后6~12h内cTnI水平均显著升高[1.59(0.82,1.95)μg/L vs 0.01(0.01,0.01)μg/L]vs[7.16(4.23,9.31)μg/L vs 0.01(0.01,0.01)μg/L,P均0.001];射频组与冷冻组术后3~5d内较术后6~12h内cTnI水平明显下降[(0.09(0.03,0.29)μg/L vs 1.59(0.82,1.95)μg/L]vs[0.45(0.13,0.86)μg/L vs 7.16(4.23,9.31)μg/L,P均0.001];(2)与射频组相比,冷冻组术后6~12h内、术后3~5d内cTnI水平明显升高(P0.01),而术前两组间cTnI水平无明显差别;(3)术后急性期冷冻组与射频组房颤复发率无差别(32%vs 25%,P=0.607)。结论冷冻球囊消融术对房颤患者心肌损伤程度大于射频消融术,但对房颤急性期复发率无影响。

The comparison and clinical significance of myocardial injury between the atrial fibrillation patients treated with radiofrequency ablation and cryoballoon ablation