【摘要】：目的探討心房顫動(簡稱房顫)患者行肺靜脈大環(huán)隔離導管射頻消融術后復發(fā)的影響因素。方法選擇房顫患者110例,包括陣發(fā)性房顫86例、持續(xù)性房顫24例。均采用肺靜脈大環(huán)隔離行射頻消融治療,術中線性消融雙側環(huán)肺靜脈。術后口服抗心律失常藥物胺碘酮及抗凝藥物華法林(或利伐沙班)3個月。術后3、6、9、12個月時隨訪心電圖與24 h動態(tài)心電圖,以手術3個月后發(fā)生的持續(xù)大于30 s的房性心律失常為房顫復發(fā)標準,評價術后的房顫復發(fā)情況。采用Logistic回歸法分析術后復發(fā)的影響因素分析,采用COX回歸分析法評價術前不同左心房前后徑對房顫患者術后復發(fā)的影響。結果術后1年陣發(fā)性房顫的復發(fā)率為30.2%,持續(xù)性房顫的復發(fā)率為50.0%。左心房前后徑是房顫患者導管消融術后復發(fā)的獨立預測因子(HR=2.33,95%CI為1.41~4.61)。左心房前后徑40 mm是導致房顫患者術后復發(fā)的危險因素。結論肺靜脈大環(huán)隔離術治療房顫患者具有一定的術后復發(fā)率,術前左心房前后徑40 mm是導致術后房顫復發(fā)的危險因素。
[Abstract]:Objective to investigate the risk factors of recurrence in patients with atrial fibrillation (AF) after radiofrequency catheter ablation. Methods 110 patients with AF, including 86 paroxysmal AF and 24 persistent AF, were selected. All patients were treated with radiofrequency ablation (RFCA), and bilateral circumferential pulmonary veins were ablated linearly during the operation. After operation, the antiarrhythmic drug amiodarone and anticoagulant warfarin (or rivastatin) were given orally for 3 months. After 3, 6, 9, 12 months follow-up electrocardiogram (ECG) and 24-hour dynamic electrocardiogram (24-h) were followed up. The recurrence of atrial fibrillation was evaluated according to the occurrence of atrial arrhythmias more than 30 s after operation. Logistic regression was used to analyze the influencing factors of postoperative recurrence. COX regression analysis was used to evaluate the effect of different anterior and posterior diameters of left atrium before operation on postoperative recurrence in patients with AF. Results the recurrence rate of paroxysmal AF and persistent AF was 30.2% and 50.0% respectively. The anteroposterior diameter of left atrium was an independent predictor of recurrence after catheter ablation in patients with AF (HR=2.33,95%CI = 1.41? 4.61). Left atrial anteroposterior diameter 40 mm is a risk factor for postoperative recurrence of AF. Conclusion the pulmonary vein great ring isolation has a certain postoperative recurrence rate in patients with atrial fibrillation. The anterior and posterior diameter of left atrium 40 mm before operation is a risk factor for recurrence of atrial fibrillation after operation. [WT5 "HZ] conclusion [WT5" BZ]
【作者單位】： 新疆維吾爾自治區(qū)人民醫(yī)院;
【分類號】：R541.75
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本文編號：2453115