Yıl: 2013 Cilt: 41 Sayı: 4 Sayfa Aralığı: 299 - 309 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Atriyum fibrilasyonu tedavisinde kriyobalon tekniği ile pulmoner ven izolasyonu: Tek merkez deneyimi

Öz:
Amaç: Kriyotermal enerji kullanılarak uygulanan pulmoner ven (PV) izolasyonu tekniği atriyum fibrilasyonu (AF) olan hastaların tedavisinde yakın zamanda kullanıma giren bir yöntemdir. Radyofrekans (RF) ablasyonuna göre işlem süresinde ve ciddi komplikasyon oranında azalma sağladığı düşünülmektedir. Bu çalışmada, kriyobalon tekniği ile AF ablasyonu uyguladığımız hastaların özellikleri ve izlem sonuçları sunuldu. Çalışma planı: Toplam 236 hastaya (126 erkek, 110 kadıın; yaş ort. 54.6±10.45; dağılım 16-78 yıl) semptomlu AF nedeniyle 28 mm kriyobalon ile PV izolasyonu yapıldı. Hastalarda en az bir antiaritmik ilaç kullanımına karşın başarısız olundu. İşlem sonrası ilk 3 ay kör dönem kabul edildi. Hastalar ortanca 14 (3-24) ay izlendi. İşlem başarısı, komplikasyonlar ve izlem sonuçları güncel Kalp Ritmi Birliği kılavuzundaki tanımlara göre belirlendi. Bulgular: Akut işlem başarısı (≥3 PV izolasyonu) %99.5 olarak saptandı. Ortalama işlem ve floroskopi süreleri 72.5±5.3 (50-90) dk ve 14±3.5 (12-24) dk idi. Majör komplikasyon 3 hastada (%1.2) gözlendi. Ortanca 14 aylık izlemde AF’siz yaşam paroksismal AF grubunda %80.6, persistan AF grubunda ise %49.2 idi. AF’si tekrarlayan 10 hastaya RF ile AF ablasyonu yapıldı. Çok değişkenli regresyon analizinde sigara kullanımı, beden kütle indeksi, paroksismal olmayan AF tipi, AF süresi (yıl), sol atriyum boyutu ve erken yineleme 3. aydan sonraki yinelemenin öngördürücüleri olarak saptandı. Sonuç: Bu çalışma Türkiye’de kriyobalon tekniği ile AF ablasyonu deneyimini yansıtan ilk seridir. Tek işlem başarısının özellikle paroksismal AF’li hastalarda istenilen düzeyde olması, komplikasyon oranının oldukça düşük olması, kribalon ile AF ablasyon tedavisinin etkin ve güvenilir olduğunu göstermektedir. Özellikle erken yineleme gelişen hastalar kör dönem sonrası yineleme açısından yakından izlenmelidir.
Anahtar Kelime:

Konular: Kalp ve Kalp Damar Sistemi Ortopedi

Pulmonary vein isolation with the cryoballoon technique in atrial fibrillation treatment: single centre experience

Öz:
Objectives: Pulmonary vein (PV) isolation with cryothermal energy is a recently introduced technique in patients with atrial fibrillation (AF). It may reduce procedural times and serious complications associated with radiofrequency (RF) ablation. We aimed to present the baseline characteristics and followup data of our study population undergoing cryoballoon AF ablation. Study design: A total of 236 patients (126 male, 110 female; mean age 54.6±10.45; range 16 to 78 years) underwent PV isolation with 28 mm cryoballoon due to symptomatic AF. These patients failed with at least one previous antiarrhythmic drug. The postprocedure in the first 3 months was defined as blanking period. Median follow-up time was 14 (3-24) months. Procedural success, complicaitons, and follow-up results were defined according to Heart Rhythm Society guidelines. Results: Acute procedural success rate (≥3 PV isolation) was 99.5%. Mean procedural and fluoroscopy times were 72.5±5.3 (50-90) min and 14±3.5 (12-24) min. Major complications were observed in 3 patients (1.2%). At the median 14 month follow-up, 80.6% of paroxysmal AF patients and 49.2% of persistant AF patients were free from AF recurrence. RF ablation was performed in 10 patients with recurrence. Smoking, body mass index, non-paroxysmal AF type, AF duration (years), left atrial size, and early recurrence were the predictors of recurrence in multivariate regression analysis. Conclusion: This study represents the first experience with cryoballoon ablation for AF in Turkey. The efficacy and safety of cryoballoon AF ablation technique was shown due to the acceptable success and low complication rates in paroxysmal AF patients. Particularly, patients with early recurrence should be closely followed-up.
Anahtar Kelime:

Konular: Kalp ve Kalp Damar Sistemi Ortopedi
Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
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APA Oto A, AYTEMIR K, CANPOLAT U, KARAKULAK U, Evranos B, ŞAHİNER L, OKUTUCU S, KAYA E, Tokgozoglu L, KABAKÇI G (2013). Atriyum fibrilasyonu tedavisinde kriyobalon tekniği ile pulmoner ven izolasyonu: Tek merkez deneyimi. , 299 - 309.
Chicago Oto Ali,AYTEMIR KUDRET,CANPOLAT Uğur,KARAKULAK Uğur Nadir,Evranos Banu,ŞAHİNER Levent,OKUTUCU Sercan,KAYA ERGUN BARIS,Tokgozoglu Lale,KABAKÇI Giray Atriyum fibrilasyonu tedavisinde kriyobalon tekniği ile pulmoner ven izolasyonu: Tek merkez deneyimi. (2013): 299 - 309.
MLA Oto Ali,AYTEMIR KUDRET,CANPOLAT Uğur,KARAKULAK Uğur Nadir,Evranos Banu,ŞAHİNER Levent,OKUTUCU Sercan,KAYA ERGUN BARIS,Tokgozoglu Lale,KABAKÇI Giray Atriyum fibrilasyonu tedavisinde kriyobalon tekniği ile pulmoner ven izolasyonu: Tek merkez deneyimi. , 2013, ss.299 - 309.
AMA Oto A,AYTEMIR K,CANPOLAT U,KARAKULAK U,Evranos B,ŞAHİNER L,OKUTUCU S,KAYA E,Tokgozoglu L,KABAKÇI G Atriyum fibrilasyonu tedavisinde kriyobalon tekniği ile pulmoner ven izolasyonu: Tek merkez deneyimi. . 2013; 299 - 309.
Vancouver Oto A,AYTEMIR K,CANPOLAT U,KARAKULAK U,Evranos B,ŞAHİNER L,OKUTUCU S,KAYA E,Tokgozoglu L,KABAKÇI G Atriyum fibrilasyonu tedavisinde kriyobalon tekniği ile pulmoner ven izolasyonu: Tek merkez deneyimi. . 2013; 299 - 309.
IEEE Oto A,AYTEMIR K,CANPOLAT U,KARAKULAK U,Evranos B,ŞAHİNER L,OKUTUCU S,KAYA E,Tokgozoglu L,KABAKÇI G "Atriyum fibrilasyonu tedavisinde kriyobalon tekniği ile pulmoner ven izolasyonu: Tek merkez deneyimi." , ss.299 - 309, 2013.
ISNAD Oto, Ali vd. "Atriyum fibrilasyonu tedavisinde kriyobalon tekniği ile pulmoner ven izolasyonu: Tek merkez deneyimi". (2013), 299-309.
APA Oto A, AYTEMIR K, CANPOLAT U, KARAKULAK U, Evranos B, ŞAHİNER L, OKUTUCU S, KAYA E, Tokgozoglu L, KABAKÇI G (2013). Atriyum fibrilasyonu tedavisinde kriyobalon tekniği ile pulmoner ven izolasyonu: Tek merkez deneyimi. Türk Kardiyoloji Derneği Arşivi, 41(4), 299 - 309.
Chicago Oto Ali,AYTEMIR KUDRET,CANPOLAT Uğur,KARAKULAK Uğur Nadir,Evranos Banu,ŞAHİNER Levent,OKUTUCU Sercan,KAYA ERGUN BARIS,Tokgozoglu Lale,KABAKÇI Giray Atriyum fibrilasyonu tedavisinde kriyobalon tekniği ile pulmoner ven izolasyonu: Tek merkez deneyimi. Türk Kardiyoloji Derneği Arşivi 41, no.4 (2013): 299 - 309.
MLA Oto Ali,AYTEMIR KUDRET,CANPOLAT Uğur,KARAKULAK Uğur Nadir,Evranos Banu,ŞAHİNER Levent,OKUTUCU Sercan,KAYA ERGUN BARIS,Tokgozoglu Lale,KABAKÇI Giray Atriyum fibrilasyonu tedavisinde kriyobalon tekniği ile pulmoner ven izolasyonu: Tek merkez deneyimi. Türk Kardiyoloji Derneği Arşivi, vol.41, no.4, 2013, ss.299 - 309.
AMA Oto A,AYTEMIR K,CANPOLAT U,KARAKULAK U,Evranos B,ŞAHİNER L,OKUTUCU S,KAYA E,Tokgozoglu L,KABAKÇI G Atriyum fibrilasyonu tedavisinde kriyobalon tekniği ile pulmoner ven izolasyonu: Tek merkez deneyimi. Türk Kardiyoloji Derneği Arşivi. 2013; 41(4): 299 - 309.
Vancouver Oto A,AYTEMIR K,CANPOLAT U,KARAKULAK U,Evranos B,ŞAHİNER L,OKUTUCU S,KAYA E,Tokgozoglu L,KABAKÇI G Atriyum fibrilasyonu tedavisinde kriyobalon tekniği ile pulmoner ven izolasyonu: Tek merkez deneyimi. Türk Kardiyoloji Derneği Arşivi. 2013; 41(4): 299 - 309.
IEEE Oto A,AYTEMIR K,CANPOLAT U,KARAKULAK U,Evranos B,ŞAHİNER L,OKUTUCU S,KAYA E,Tokgozoglu L,KABAKÇI G "Atriyum fibrilasyonu tedavisinde kriyobalon tekniği ile pulmoner ven izolasyonu: Tek merkez deneyimi." Türk Kardiyoloji Derneği Arşivi, 41, ss.299 - 309, 2013.
ISNAD Oto, Ali vd. "Atriyum fibrilasyonu tedavisinde kriyobalon tekniği ile pulmoner ven izolasyonu: Tek merkez deneyimi". Türk Kardiyoloji Derneği Arşivi 41/4 (2013), 299-309.