| Background: Atrial fibrillation(AF)is one of the most common arrhythmia in clinical.There is 10 million patients with atrial fibrillation in our country.As the growth of the age,the incidence of atrial fibrillation is also increasing year by year.The incidence of AF in the elderly over the age of 50 to 1%,and the incidence of AF in the elderly over the age of 80 is as high as 10%.With the advent of an aging society,the number of atrial fibrillation in our country will increase in future.thrombosis is likely to formed in the left atrial appendage.If thrombosis fall off,cerebral embolism will be occurred.The death and disableed caused by atrial fibrillation increased the cost of health care.The cryoablation(Medtronic USA)is experimental group and the radiofrequency ablation(WS USA)is control group.After matching of the baseline data analysis,this study included in 40 cases of patients.Every group included twenty patients.There were no statistically significant difference between two groups of patients with baseline data comparison.Objective: The aim of this study was to compare the efficiency and safety between Cryoablation and radiofrequency ablation in paroxysmal atrial fibrillation.All of the patients informed consent signed surgery.Methods: This study analyzed 238 paroxysmal atrial fibrillation cases who operative treatment between January 2015 to September 2017 in Jilin university first hospital.All patients in the study were treated by class I and class III anti-arrhythmic drugs,but the effectiveness is negligible.Result: In the cryoablation group,78 pulmonary vein achieved complete isolation which measured by Achieve eletrode in all 79 pulmonary vein.The overall pulmonary vein isolation rate was 98.7%.The average operation time was 111.00 ±18.82 minutes.In the radiofrequency ablation group,77 pulmonary vein achieved complete isolation which measured by Lasso eletrode in all 79 pulmonary vein.The overall pulmonary vein isolation rate was 97.4%.The average operation time was 130.50±15.80 minutes which longer than cryoablation,the difference was statistically significant(p = 0.001).Cryoablation group four and six patient after 3 months and 6 months respectively.Surgery recurrence rates were 20%(4/20)and 30%(6/20)respectively.The radiofrequency ablation group six and eight patient after 3 months and 6 months respectively.Surgery recurrence rates were 20%(4/20)and 30%(6/20)respectively.The surgical success rate of two groups have no statistical significance(p > 0.05).Cryoablation and radiofrequency ablation group have 5 patients received treatment in patients with recurrent.There are two patients again radiofrequency ablation in radiofrequency ablation group.One patient restored sinus rhythm result from electrical cardioversion.Two groups of patients in hospital readmission rate(25% vs25 % p = 1.000),readmission cardioerter(0.00% vs5.00 % p = 0.661),reoperation rate(10% vs20 % p = 0.661)has no statistical difference.Patient appear phrenic nerve paralysis,but phrenic nerve functional recovery when stop frozen.There are 2 cases of complications in radiofrequency ablation group.Conclusions 1.There are no obvious difference in the rate of pulmonary vein isolation immediately and in the recurrence rate between cryoablation and radiofrequency ablation which demonstrated that the effect of cryoablation in the treatment of paroxysmal atrial fibrillation is not inferior to radiofrequency ablation.2.Operation time of cryoablation is shorter than radiofrequency ablation.3.The LAD is independent risk factors for recurrence of atrial fibrillatio 4.Phrenic nerve paralysis is a common complication of cryoablation.Stimulating phrenic nerve in the process of freezing is a good way to avoid the happening of phrenic nerve paralysis. |
PDF Full Text Request