冷冻球囊消融与电复律治疗初发持续性心房颤动疗效及安全性比较OA

Objective To compare the efficacy and safety of cryoballoon ablation versus electrical cardioversion in patients with first-episode,untreated persistent atrial fibrillation.Methods Patients with first-episode persistent atrial fibrillation who received cryoballoon ablation or electrical cardioversion in our hospital were enrolled.Propensity score matching was applied to balance baseline characteristics,and a total of 70 patients with atrial fibrillation duration<1 year were finally included,with 35 in the cryoballoon group and 35 in the cardioversion group.The primary efficacy endpoint was the freedom from atrial fibrillation recurrence at 1 year post-procedure,and the safety endpoint was the incidence of major complications.Results The 1-year freedom from recurrence rate was significantly higher in the cryoballoon group than in the cardioversion group(76.6%vs.45.0%,P<0.05).No significant difference was observed between the 2 groups in the incidence of severe complications such as stroke or cardiac tamponade.Left atrial diameter was identified as an independent risk factor for recurrence after cryoballoon ablation(hazard ratio=1.319,P=0.046),whereas atrial fibrillation duration was an independent risk factor for recurrence after cardioversion(hazard ratio=1.131,P=0.037).Conclusions For patients with first-episode persistent atrial fibrillation,cryoballoon ablation is superior to electrical cardioversion in maintaining sinus rhythm,with a favorable safety profile.Left atrial diameter and atrial fibrillation duration are important predictors of recurrence after each treatment modality,which may help guide individualized clinical decision-making.