冷冻球囊消融治疗心房颤动术中迷走神经反射对复发的影响

目的 研究冷冻球囊消融治疗心房颤动（房颤）术中出现迷走神经反射对手术成功率的影响。 方法 分析行冷冻球囊消融的阵发性/持续性房颤患者103例，根据术中是否发生迷走神经反射分为两组:迷走神经反射组（n=40）和非迷走神经反射组（n=63）。比较两组患者的基线资料，术中参数及即刻成功率。术后随访至少12个月，观察房颤的复发率。 结果 两组在并发高血压病、糖尿病和脑梗死以及左房内径等方面均无统计学差异。两组术中应用23 mm小球囊的比例、手术时间、X线曝光时间、曝光量也均无显著差异。术中出现较长时间严重迷走神经反射2例，经心室起搏、静注阿托品后恢复。术后随访12~21（13.6±2.3）个月，迷走反射组复发14例（35%），非迷走神经反射复发20例（32%），两组间无显著统计学差异。 结论 冷冻球囊隔离肺静脉治疗房颤术中出现迷走神经反射不影响房颤术后复发。

Influence of vagal reflex after cryoballoon ablation on the recurrence of atrial fibrillation

AIM To investigate the effect of vagal reflexes after cryoballoon ablation on the recurrence of atrial fibrillation (AF). METHODS One hundred and three consecutive patients with paroxysmal/persistent AF underwent cryoballoon ablation. They were divided into two groups based on whether vagal reflexes occurred after cryoballoon ablation. The baseline characteristics, ablation parameters, and success rate were compared between the two groups. The primary endpoint was the recurrence rate of atrial fibrillation after 12-month post ablation. RESULTS There were a total of 40 patients in the vagal reflex group and 63 patients in the control group. There were no significant differences in hypertension, diabetes mellitus, cerebral infarction, or left atrial diameter between the two groups. There were no significant differences in the application of a 23 mm balloon, operation times, or X-ray exposures between the two groups. There were 2 patients that had longer time of severe vagal reflex, which recovered after ventricular pacing and injection of atropine. AF recurrence occurred in 14 patients (35%) in the vagal reflex group and in 20 (32%) in the control group. The recurrence between the two groups had no significant difference. CONCLUSION Vagal reflex during cryoballoon ablation of AF has no significant influence on postablation recurrence of AF.