术后早期应用抗心律失常药物对环肺静脉消融术治疗心房颤动复发的影响  

Effects of antiarrhythmic drug use on atrial fibrillation recurrence in atrial fibrillation patients post circumferential pulmonary vein ablation

作　　者：吴钢[1] 江洪[1] 黄从新[1] 杨波[1] 黄鹤[1] 王跃岭[1] 王晓红[1] 刘华芬[1] 杨新红[1] 

机构地区：[1]武汉大学人民医院心内科,430060

出　　处：《中华心血管病杂志》2008年第7期623-626,共4页Chinese Journal of Cardiology

基　　金：国家自然科学基金（30470704）;湖北省“十一五”攻关项目（2006AA301857）

摘　　要：目的通过前瞻性、随机对照的临床试验探讨环肺静脉消融术（circumferential ablation of pulmonary vein，CAPV）治疗心房颤动（房颤）术后应用抗心律失常药物对复发率的影响。方法74例房颤患者，阵发性房颤41例，持续性房颤33例，均接受CAPV，术前随机分为A、B两组，A组术后不用抗心律失常药物，B组术后3个月内使用抗心律失常药物治疗。所有患者通过心电图和Holter进行随访。结果所有患者均顺利完成CAPV手术。术后随访时间两组差异无统计学意义。早期复发：A组14例（37．8％），B组5例（13．5％），B组低于A组，差异有统计学意义（P〈0、01）。远期复发：A组11例（29．7％），B组9例（24．3％），两组之间差异无统计学意义。更远期复发：A组3例（8．1％），B组3例（8．1％），两组比较差异无统计学意义。总体复发率：A组为37．8％，B组为32．4％，两组差异无统计学意义。结论术后短期应用抗心律失常药物只能降低CAPV术的早期复发，对远期、更远期复发及总体复发率无显著影响。Objective This prospective and randomize-controlled trial was designed to investigate the effects of antlarrhythmic drug use （AADs） on atrial fibrillation （AF） recurrence in atrial fibrillation patients post circumferential pulmonary vein ablation （CAPV） Methods Seventy-four consecutive AF patients underwent CAPV （41 paroxysmal and 33 drug refractory AF） were randomly assigned to receive placebo （Group A） or AADs （Group B） for 3 months. Monthly standard electrocardiograms （ECG） and Holter monitoring were performed to assess AF recurrences during 17 -28 months follow-up. Results CAPV was successful in all patients. The recurrence rate of AF in Group B was significantly lower than that in Group A at 3 months post CAPV （ 13.5% vs. 37. 8%, P 〈 0.01 ） and similar thereafter （29. 7% vs. 24.3% at 12 months and 8. 1% vs. 8. 1% at more than 12 months, all P〉0.05）. There was also no significant difference in terms of total recurrence rate between the two groups （ 37. 8% vs. 32.4%, P 〉 0.05）. Conclusion Post CAPV antiarrhythmic drug therapy could only decrease the early AF recurrence rate but was not effective for decreasing AF recurrence rate on later stage.

关 键 词：心房颤动 导管消融术 抗心律失常药物 

分 类 号：R686[医药卫生—骨科学]