本文選題：陣發(fā)性房顫 + 心臟導(dǎo)管射頻消融��； 參考：《山東醫(yī)藥》2017年30期

【摘要】：目的比較兩種不同心臟導(dǎo)管射頻消融術(shù)(RFCA)術(shù)式即環(huán)肺靜脈隔離(CPVI)與環(huán)肺靜脈隔離聯(lián)合左心房頂部線性消融(CPVI+LARA)治療陣發(fā)性心房顫動(dòng)(簡(jiǎn)稱房顫)的臨床療效。方法選擇因藥物治療無(wú)效或無(wú)法耐受抗心律失常藥物而接受RFCA治療的陣發(fā)性房顫患者174例,根據(jù)消融術(shù)式不同分為CPVI組84例、CPVI+LARA組90例。CPVI組行CPVI,以肺靜脈完全隔離為消融終點(diǎn)。CPVI+LARA組行CPVI達(dá)到肺靜脈完全隔離后,繼續(xù)行LARA消融左心房頂部線,以雙側(cè)肺靜脈完全隔離及左心房頂部線完全阻滯為消融終點(diǎn)。術(shù)后通過(guò)門診隨訪24~36個(gè)月,計(jì)算兩組的消融成功率,比較兩組手術(shù)時(shí)間以及X線曝光時(shí)間、術(shù)后并發(fā)癥發(fā)生率,術(shù)后6個(gè)月采用心臟彩超檢查評(píng)價(jià)左心房功能。結(jié)果兩組手術(shù)時(shí)間和X線曝光時(shí)間差異均無(wú)統(tǒng)計(jì)學(xué)意義(P均0.05)。CPVI組、CPVI+LARA組消融成功率分別為73.8%(62/84)、86.7%(78/90),CPVI+LARA組消融成功率高于CPVI組(P0.05)。兩組術(shù)后并發(fā)癥發(fā)生率差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。兩組術(shù)后左心房前后徑均低于術(shù)前,左心室射血分?jǐn)?shù)均高于術(shù)前(P均0.01)。結(jié)論 CPVI+LARA可較CPVI顯著提高陣發(fā)性房顫的消融成功率,能改善心功能,且不增加手術(shù)時(shí)間及術(shù)中X線曝光時(shí)間。
[Abstract]:Objective to compare the clinical effects of two different radiofrequency catheter ablation (RFCA) methods: CPVI) and CPVI combined with linear ablation of left atrial top (LTA) in the treatment of paroxysmal atrial fibrillation (AF). Methods 174 patients with paroxysmal atrial fibrillation who were treated with RFCA because of ineffective or intolerable antiarrhythmic drugs were selected. According to the different types of ablation, CPVI was divided into CPVI group (n = 84), CPVI group (n = 90), CPVI group (n = 90). The end point of ablation was complete isolation of bilateral pulmonary veins and complete block of the parietal line of left atrium. The successful rate of ablation was calculated, the time of operation, the time of X-ray exposure, the incidence of postoperative complications and the left atrial function were evaluated by echocardiography 6 months after operation. Results there was no significant difference in the operative time and X-ray exposure time between the two groups. The successful rate of ablation in CPVI LARA group was 73.8%. The successful rate of ablation in CPVI LARA group was higher than that in CPVI group (86.7% / 90%), and that in CPVI LARA group was higher than that in CPVI group (P 0.05). There was no significant difference in the incidence of postoperative complications between the two groups (P 0.05). The anterior and posterior diameter of left atrium in both groups was lower than that before operation, and the ejection fraction of left ventricle was higher than that before operation (P < 0.01). Conclusion CPVI Lara can significantly improve the success rate of ablation of paroxysmal atrial fibrillation, improve cardiac function, and not increase the operative time and X-ray exposure time of paroxysmal atrial fibrillation.
【作者單位】： 南方醫(yī)科大學(xué)珠江醫(yī)院;
【基金】：南方醫(yī)科大學(xué)臨床啟動(dòng)計(jì)劃項(xiàng)目(LC2016ZD022)
【分類號(hào)】：R541.75

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