Preferred treatment for atrial fibrillation with surgery

Atrial fibrillation is the most common persistent arrhythmia, which can lead to reduced quality of life, increased hospitalization and mortality, heart failure, stroke, etc. The poor effectiveness of drug treatment and the potential for serious side effects impose a heavy medical and economic burden on society. According to conservative estimates, there are at least 8 million patients with atrial fibrillation in China. Professor Ma Jian, director of the fifth cardiology department of Fu Wai Cardiovascular Hospital and one of the leaders of the electrophysiology team, said that cryoballoon ablation for atrial fibrillation is a safe and effective treatment technology with low complication rate and good patient tolerance. Therefore, cryoballoon ablation should be actively considered for patients for whom antiarrhythmic drug therapy is ineffective, and some symptomatic paroxysmal atrial fibrillation, such as young patients, can be preferred to cryoballoon ablation. Since the successful implementation of the first cryoballoon ablation procedure for atrial fibrillation in China by Professor Ma Jian’s electrophysiology team at Fu Wai Cardiovascular Hospital last year, the country has been the first to complete more than 1,000 cryoballoon ablation procedures for atrial fibrillation, which has become a new technology for the mature treatment of atrial fibrillation in China. Since the cryoballoon was applied to clinical practice, more than 80,000 cases of atrial fibrillation have been completed in Europe, America and other countries. From the current clinical data, the traditional cold saline infusion radiofrequency ablation procedure is time-consuming and requires a large amount of saline infusion during the procedure, which poses a hidden danger to the cardiopulmonary function of older patients, and the burning sensation and pain during radiofrequency ablation can cause pain to patients. In comparison, the cryoballoon procedure time and X-ray exposure time are significantly shortened, intraoperative saline infusion is not required, patients do not have the pain commonly associated with traditional surgery, and the incidence of serious complications such as cardiac perforation and pericardial tamponade is significantly reduced, thus having the advantages of being safer, simpler, more effective, and better tolerated by patients. A large international clinical study showed that 70% of patients who underwent a single cryoballoon ablation had no recurrence of atrial fibrillation for one year without antiarrhythmic drugs; this was significantly higher than the 7.3% of patients who received antiarrhythmic drugs; the percentage of patients who underwent surgery again for recurrence of atrial fibrillation was 19%, much lower than the 30%-40% of patients who underwent radiofrequency ablation. Therefore, frozen balloon ablation of AF has been recommended by many international academic groups as one of the preferred treatments for paroxysmal AF.