Radiofrequency catheter ablation for atrial fibrillation is superior to drug therapy in maintaining sinus rhythm, improving symptoms, activity tolerance and quality of life, and has become an important treatment for symptomatic atrial fibrillation.
However, radiofrequency catheter ablation also has some problems: 1. The intervention time is long, and the result of radiofrequency catheter ablation has a great relationship with the experience and technique of the operator. It takes a long time to train a qualified ablation surgeon and cannot be widely promoted. Clinically, when faced with the high incidence of atrial fibrillation, a mature and good surgeon is simply a drop in the bucket and cannot meet the surgical needs of the majority of atrial fibrillation patients. 2, safety has room for improvement. 3, the incidence of patient pain during radiofrequency catheter ablation is high. 4, the possibility of thrombus formation is still greater for technically immature operators. Radiofrequency catheter ablation destroys the overall structure of the cells and the fibrous connective tissue around the cells, and the surface of the cells at the ablation site is relatively unsmooth, increasing the possibility of thrombus formation. This leads to a more concentrated selection of hospitals, equipment and doctors by patients, making RF ablation of atrial fibrillation medical resources even more scarce. Li Yigang, Department of Cardiovascular Medicine, Shanghai Xinhua Hospital As a new technology and procedure, cryoballoon ablation provides a new ablation energy source and method for clinical practice. Through the heat absorption and evaporation of liquid refrigerant, the temperature of the ablation site is lowered, thus causing necrosis of the target tissue. However, the scar boundary is clear and the tissue architecture is not destroyed, which reduces the risk of thrombus attachment and the risk of damaging the surrounding tissues. There are more and more foreign reports on cryoballoon for paroxysmal atrial fibrillation, but there is not much experience on cryoballoon ablation for persistent atrial fibrillation. This cryoballoon ablation for persistent atrial fibrillation in a patient with persistent atrial fibrillation, which was successfully performed by Director Li Yigang of Xinhua Hospital, was the first of its kind in China. The patient was a male, 78 years old, suffering from paroxysmal atrial fibrillation for 5 years and persistent for 5 months. He had been treated with various antiarrhythmic drugs, but the results were poor. The patient was given a small amount of sedative medication and a 28 mm cryoablation balloon catheter was used to cryoablate the patient’s four pulmonary veins two to three times, 4 minutes each, with a minimum ablation temperature of -40°C or less. Pulmonary vein cryoablation was performed with multiple interchanges of atrial fibrillation and regular atrial flutter. Finally, it became persistent atrial flutter without any antiarrhythmic drug. Then a routine marker test was performed and radiofrequency ablation was performed on the anterosuperior aspect of the left atrium, where atrial flutter was terminated. No intraoperative complications such as diaphragmatic paralysis occurred. The operative time was over 3 hours with 34.3 minutes of radiation. This technique can effectively improve the safety of surgery, provide more and better clinical treatment options for patients; and cryoballoon ablation shortens the operation time and learning curve, which wins a wide space for the growth of the medical staff and brings benefits to the majority of atrial fibrillation patients, with far-reaching impact.