环肺静脉大环消融和肺静脉节段电隔离治疗阵发性心房颤动结果对比  

Comparison of the results between circumferential pulmonary vein ablation and segmental pulmonary isolation for treatment of paroxysmal atrial fibrillation

作　　者：杨东辉[1] 高连君[1] 张树龙[1] 夏云龙[1] 王莹琦[1] 丛培欣[1] 杨延宗[1] 

机构地区：[1]大连医科大学附属第一医院心内科,116011

出　　处：《中华心律失常学杂志》2008年第4期275-278,共4页Chinese Journal of Cardiac Arrhythmias

摘　　要：目的环肺静脉大环消融（CPVA）和肺静脉节段电隔离（SPVI）是目前导管射频消融治疗阵发性心房颤动（房颤）的两大主流术式，本文研究目的是验证“CPVA对阵发性房颤的有效率比SP-VI高”这一假设，同时对比两种消融术式的其他治疗结果。方法2006年1月至2007年12月入选阵发性房颤病人129例，SPVI和CPVA两组分别为64例和65例。排除标准为，房颤持续时间〉72h，接受过导管消融的复发病例。结果SPVI和CPVA组病人成功率分别为78．1％、78．5％；并发症发生率分别为7．8％、10．6％，差异无统计学意义。严重并发症3．9％。X线曝光时间SPVI组多于CPVA组，消融术时间CPVA组长于SPVI组。SPVI组的射频放电时间少于CPVA组。CPVA组术后房性心动过速／心房扑动发生率明显高于SPVI组（12．3％vs3．1％）。结论SPVI和CPVA两种消融术式均能够比较安全有效地控制阵发性房颤的发作，治疗效果类似。Objective Circumferential pulmonary vein ablation （CPVA） and segmental pulmonary vein isolation （SPVI） are two popular ablation strategies for the atrial fibrillation. We hypothesized that CPVA approach was superior to SPVI approach for the treatment of paroxysmal atrial fibrillation （PAF）. Methods One hundred and twenty-nine patients with symptomatic and drug refractory PAF were enrolled in CPVA group （ n = 65 ） and SPVI group （n = 64）. No any atrial tachyarrhythmias （ 〉 30 s） in a 24 hour Hoher monitoring at 3rd month,6th month,9th month and 12th month after ablation was regarded as a successful treatment procedure. Results On the basis of the results of the 4 times 24 hour Holter monitoring, the successful rate in CPVA and SPVI were 78.5% and 78. 1% ,respectively （P 〉0. 5） ;complication rate were 10. 6% and 7. 8% ,respectively （P 〉 0.5 ）. However, there were more post-ablation atrial reentrant tachycardias in CPVA group than those in SPVI group （ 12. 3% vs 3.1% ,P 〈 0. 05 ）. Conclusion This study demonstrates no superiority of CP- VA over SPVI for the treatment of PAF in terms of efficacy and safety.

关 键 词：阵发性心房颤动 环肺静脉大环消融 肺静脉节段电隔离 

分 类 号：R541.75[医药卫生—心血管疾病] R323.43[医药卫生—内科学]