本文選題：二代冷凍球囊 + 早期復發(fā)率�。� 參考：《浙江大學》2017年碩士論文

【摘要】：研究目的心房顫動(AF,簡稱房顫)是目前最常見的持續(xù)性心律失常。房顫在總?cè)巳旱陌l(fā)病率較高,約1%-2%,并且隨著年齡的增長,房顫的發(fā)病率也隨之增長,有研究表明,在80歲以上的人群中甚至高達近8%。同時,除了房顫疾病自身的痛苦,房顫帶來的各種并發(fā)癥也讓患者飽受折磨。隨著射頻消融術的出現(xiàn),房顫的治療迎來了里程碑式進展,第一次能通過微創(chuàng)手術進行根治,各中心手術成功率在50%-80%不等。而冷凍球囊消融術作為陣發(fā)性心房顫動的新消融手段,有Meta分析比較兩者術后1年成功率顯示兩術式臨床療效相當[1]�，F(xiàn)在,加以改進的二代冷凍球囊的問世,冷凍效率大大提高,冷凍消融技術得到了進一步提升。本文將就二代冷凍球囊消融術的早期復發(fā)率及復發(fā)因素進行探討,以便早期進行干預治療。研究方法這是一個單中心的回顧性研究,總共入選了 2016.8至2016.12期間共55例進行二代冷凍球囊消融的陣發(fā)性房顫患者。入選患者均用28mm冷凍球囊在肺靜脈進行隔離,每次冷凍時間為3min,若未完全隔離行射頻消融術隔離。術后1月、3月、6月時隨訪,每3個月行7天復查動態(tài)心電圖。研究結(jié)果所有患者肺靜脈電位都成功隔離,其中2人電復律后轉(zhuǎn)竇性心律。術后3月共有6人復發(fā),早期復發(fā)率11.8%。早期復發(fā)組與維持竇律組患者的基線NT-proBNP之間有顯著性差異(早期復發(fā)組vs維持竇律組:287.0±195.9vs161.9±118.6 P0.05)。其他 hs-CRP 等沒有顯著性差異。結(jié)論陣發(fā)性房顫應用二代冷凍球囊消融術能較好地隔離肺靜脈,術后具有較低的早期復發(fā)率。NT-proBNP是二代球囊冷凍術后早期復發(fā)率的影響因素。對于術前NT-proBNP高的患者術后更需密切關注,及時予早期治療。
[Abstract]:Objective Atrial fibrillation (AF) is the most common persistent arrhythmia. The incidence of atrial fibrillation in the total population is higher, about 1- 2, and with the increase of age, the incidence of atrial fibrillation also increases. Some studies show that the incidence of atrial fibrillation is as high as nearly 8% in the population over 80 years old. At the same time, in addition to the pain of the disease itself, atrial fibrillation brings a variety of complications to the patient suffering. With the emergence of radiofrequency ablation, the treatment of atrial fibrillation has ushered in a milestone progress, the first time can be cured by minimally invasive surgery, the success rate varies from 50% to 80%. As a new method of ablation of paroxysmal atrial fibrillation, Meta analysis showed that the two methods had the same clinical effect. Now, with the advent of the improved second generation cryopreservation balloon, the efficiency of cryopreservation has been greatly improved, and the technique of cryoablation has been further improved. This article will discuss the early recurrence rate and recurrence factors of second generation cryopreservation balloon ablation in order to carry out early intervention therapy. Methods the study was a single-center retrospective study of 55 patients with paroxysmal atrial fibrillation who underwent second-generation balloon ablation between 2016.8 and 2016.12. All the patients were isolated in pulmonary vein with 28mm cryopreservation balloon for 3 mins each time. If not completely isolated, the isolation of radiofrequency ablation was performed. The patients were followed up for 1 month, 3 months and 6 months after operation. Results all patients were sequestered successfully, 2 of them switched to sinus rhythm after cardioversion. A total of 6 patients recurred at 3 months after operation, with an early recurrence rate of 11.8%. There was significant difference in baseline NT-proBNP between early recurrence group and maintenance sinus rhythm group (early recurrence group vs maintenance sinus rhythm group: 287.0 鹵195.9vs161.9 鹵118.6 P 0.05). There was no significant difference in other hs-CRP et al. Conclusion paroxysmal atrial fibrillation with second generation cryopreservation balloon ablation can well isolate pulmonary veins. The low early recurrence rate of paroxysmal atrial fibrillation. NT-proBNP is the influencing factor of the early recurrence rate after second generation balloon cryopreservation. Patients with high NT-proBNP need close attention and early treatment.
【學位授予單位】：浙江大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R541.75
，

本文編號：1795533