vestarВестник аритмологииJournal of Arrhythmology1561-86412658-7327НАО «Инкарт»10.35336/VA-1504vestar-1563Research ArticleОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯORIGINAL ARTICLESСравнительный анализ трехлетней эффективности катетерной аблации фибрилляции предсердий с использованием модуля Ablation Index и криобаллона второго поколенияComparative analysis of three-year efficacy of catheter ablation of atrial fibrillation using the Ablation Index module and the second-generation cryoballoonhttps://orcid.org/0009-0006-1678-9175АзизовС. Н.AzizovS. N.

Азизов Сардор Норматович 

Пермь, ул. Маршала Жукова, д. 35 

Azizov Sardor 

Perm, 35 Marshal Zhukov str. 

azizov.s89@mail.ruhttps://orcid.org/0009-0001-2835-9571ХузиахметовР. Д.KhuziakhmetovR. D.

Пермь, ул. Маршала Жукова, д. 35 

Perm, 35 Marshal Zhukov str. 

https://orcid.org/0000-0002-8501-4801ЛяшенкоВ. В.LyashenkoV. V.

Калининград, Калининградское шоссе, д.4 

Kaliningrad, 4 Kaliningradskoye Shosse 

https://orcid.org/0000-0002-0945-8208БеловВ. А.BelovV. A.

Пермь, ул. Маршала Жукова, д. 35 

Perm, 35 Marshal Zhukov str. 

https://orcid.org/0009-0005-1750-1586КоженовА. Т.KozhenovA. T.

Москва, ул. Вешняковская, д. 23 

Moscow, 23 Veshnyakovskaya str. 

ФГБУ «Федеральный центр сердечно-сосудистой хирургии имени С.Г.Суханова» МЗ РФРоссияFSBI “Federal Center of Cardiovascular Surgery named after S.G.Sukhanov” of the MH RFRussian FederationФГБУ «Федеральный центр высоких медицинских технологий» МЗ РФРоссияFSBI “Federal Center of High Medical Technologies» of the MH RFRussian FederationГБУЗ «Городская клиническая больница №15 им О.М.Филатова Департамента здравоохранения города Москвы»РоссияSBI «Municipal Clinical Hospital No.15 named after O.M.Filatov» of Department of Health of MoscowRussian Federation2025050920253233744Copyright © Азизов С.Н., Хузиахметов Р.Д., Ляшенко В.В., Белов В.А., Коженов А.Т., 20252025Азизов С.Н., Хузиахметов Р.Д., Ляшенко В.В., Белов В.А., Коженов А.Т.Azizov S.N., Khuziakhmetov R.D., Lyashenko V.V., Belov V.A., Kozhenov A.T.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://vestar.elpub.ru/jour/article/view/1563

Цель. Сравнить непосредственные и отдаленные результаты катетерного лечения фибрилляции предсердий (ФП) после криобаллонной аблации (КБА) легочных вен (ЛВ) с использованием криобаллона второго поколения и радиочастотной аблации (РЧА) ЛВ вен на навигационной системе с катетером c датчиком давления «катетерткань» c использованием модуля Ablation Index (AI).Материал и методы исследования. В исследование были включены 199 пациентов, направленных на процедуру катетерной изоляции ЛВ в период 2018-2021 гг. Пациенты были распределены на две группы: исследуемая группа - 110 пациентов, у которых изоляция ЛВ достигалась путем РЧА с помощью катетера с модулем AI; контрольная группа - 89 пациентов, подвергшиеся КБА ЛВ криобаллоном второго поколения. Период наблюдения был ограничен 36 месяцами, средний период наблюдения составил 27,9±14,2 месяцев.Результаты. Трехлетняя эффективность КБА и РЧА ЛВ является сопоставимой (свобода от предсердных тахиаритмий в группе РЧА - 0,61±0,05, в группе КБА - 0,62±0,05, (Log-Rank test, p = 0,896)) при сходной частоте и структуре осложнений (3,6% (4) vs. 4,5 (4), p=0,759). Частота рецидивов ФП в «слепом» периоде достоверно ниже в группе РЧА (1,8% (2) vs. 9,0% (8) в группе РЧА, p=0,045). Длительность оперативного вмешательства значимо меньше в группе криоаблации (РЧА 92,7±20,9 мин, КБА 83,9±19,6 мин, p=0,005). Потребность в повторном оперативном вмешательстве сопоставима для обеих групп (РЧА 21,8% (n=24), КБА 30,3% (n=27), p=0,171).Заключение. Сравнительный анализ трехлетней эффективности радиочастотной антральной изоляции легочных вен катетером с использованием модуля AI продемонстрировал сопоставимость результатов с аблацией криобаллоном второго поколения. При этом в «слепом» периоде наблюдения группа РЧА характеризовалась статистически значимым снижением частоты рецидивов предсердной тахиаритмии по сравнению с группой КБА.

Aim. To compare immediate and long-term outcomes of catheter-based atrial fibrillation (AF) treatment following pulmonary vein (PV) cryoballoon ablation (CBA) using the second-generation cryoballoon and PV radiofrequency ablation (RFA) performed on the navigation system using the contact force-sensing catheter with the AI module.Methods. The study included 199 patients referred for PV isolation between 2018 and 2021. Patients were divided into two groups: the study group (n=110) underwent PV isolation via RFA using the catheter with the AI module; the control group (n=89) underwent PV CBA using the second-generation cryoballoon. The follow-up period was limited to 36 months, with a mean follow-up of 27.9 ± 14.2 months.Results. The three-year efficacy of CBA and RFA using the AI module was comparable (freedom from atrial tachy­ arrhythmias: RFA group 0.61±0.05, CBA group 0.62±0.05 (Log-Rank test, p = 0.896)), with similar complication rates and profiles (3.6% (n=4) vs. 4.5% (n=4), p=0.759). The AF recurrence rate during the blanking period was significantly lower in the RFA group using the AI module (1.8% (n=2) vs. 9.0% (n=8) in the CBA group, p=0.045). Procedure duration was significantly shorter in the cryoablation group (RFA 92.7±20.9 min, CBA 83.9±19.6 min, p=0.005). The need for repeat intervention was comparable between groups (RFA 21.8% (n=24), CBA 30.3% (n=27), p=0.171).Conclusion. Comparative analysis of the three-year efficacy of radiofrequency antral pulmonary vein isolation using the catheter with the “Ablation Index” (AI) module demonstrated results comparable to ablation with the secondgeneration cryoballoon. Furthermore, during the blanking period, the RFA group showed a statistically significant reduction in AF recurrence compared to the CBA group.

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The authors declare that there are no conflicts of interest present.