阵发性心房颤动射频导管消融术后生活质量随访  

Quality of life in patients with paroxysmal atrial fibrillation after pulmonary vein isolation by radiofrequency catheter ablation

作　　者：郑朝阳[1] 吴书林[2] 杨平珍[2] 詹贤章[2] 陈纯波[2] 

机构地区：[1]新疆医科大学第一附属医院心内科,乌鲁木齐830054 [2]广东省心血管病研究所

出　　处：《中华心律失常学杂志》2004年第4期215-218,共4页Chinese Journal of Cardiac Arrhythmias

摘　　要：目的　探讨经导管射频消融治疗阵发性心房颤动 (房颤 )的安全性、有效性以及对生活质量的影响。方法　 30例药物难治性阵发性房颤 ,在环状电极导管 (Lasso导管 )指导标测下行肺静脉或上腔静脉电隔离 ,术后随访并行隔离术前后生活质量调查。结果　有 2 9例达消融终点 ,随访 1～ 2 6个月 ,17例消融成功 ,无需药物可以维持窦性心律 ,加用以前无效的抗心律失常药物后 ,有 2 2例无房颤复发。生活质量(QOL)调查示隔离术前后相比 ,SF 36量表中除肌体疼痛差异无显著性外 ,其它 7项指标 :躯体功能、躯体角色、总的健康状况、活力、社会功能、情感角色和心理健康 ,术后均有改善 (P <0 0 5 ) ;而症状列表中除胸痛外 ,心悸、心动过速、呼吸困难、头昏、活动受限 ,术后均有改善 (P <0 0 5 )。结论　部分药物难治性房颤患者可行射频导管消融肺静脉电隔离治疗 ,成功地消除房颤可明显提高患者的QOL且改善症状。Objective To investigate the efficacy,safety and effects on quality-of-life(QOL)of pulmonary vein isolation by radiofrequency catheter ablation in patients with paroxysmal atrial fibrillation(AF).Methods Guided by Lasso mapping catheter,electrical isolation of the pulmonary veins or superior vena cava were performed on thirty drug refractory AF patients.QOL was measured with the SF-36 and symptom checklist survey before and after the procedure.Results Twenty-nine patients achieved the procedural endpoint.After a mean follow-up of 1～26(7.7±6.2)months,17 patients were free from AF without antiarrhythmic drug,5 patients were recurrence-free taking previously ineffective drug.There was a significant improvement in QOL after a successful catheter ablation(except for body pain).There was also a significant change in clinical symptoms(except for chest pain).Conclusions Pulmonary vein isolation by radiofrequency catheter ablation is safe for the treatment of drug refractory paroxysmal AF patients,and there is a significant improvement in QOL and symptoms after the successful procedure.

关 键 词：生活质量 术后 阵发性心房颤动 随访 QOL 难治性 术前 药物 患者 射频导管消融术 

分 类 号：R541.7[医药卫生—心血管疾病]