冲洗射频消融治疗风湿性心脏病合并心房颤动25例  

Saline -irrigated radiofrequency ablation for chronic atrial fibrillation associated with rheumatic valve disease

作　　者：隋红阳[1] 乔晨晖[1] 张新[1] 罗鸿[1] 张伟华[1] 

机构地区：[1]郑州大学第一附属医院心外科,450052

出　　处：《中国实用医刊》2009年第6期26-27,共2页Chinese Journal of Practical Medicine

摘　　要：目的观察冲洗式射频消融改良迷宫Ⅲ型手术（IRFMM）加瓣膜置换治疗心房颤动（AF）的疗效。方法选择25例风湿性心脏瓣膜病合并慢性AF患者，在心内直视下行IRFMM同期行瓣膜替换术，并用胺碘酮辅助治疗3个月。结果无手术死亡。射频消融时间为（15±7）min，体外循环时间为（122±50）min，主动脉阻断时间为（65±17）min。25例患者均在心脏复跳时自动或经除颤立即恢复窦性心律，2例在24h内转为结性心律，5例在术后1周内出现窦性心律伴阵发性AF经胺碘酮治疗后均转为窦性心律。术后随访6～48个月，平均（27±4）个月，23例（92％）窦性心律者心律稳定无AF复发，结性心律2例。结论本方法达到了治疗房颤的目的，简捷安全，远期疗效稳定.Objective To observe the outcomes of saline irrigated radiofrequency modified maze Ⅲ procedure （IRFMM） and valve replacement operation for atrial fibrillation. Methods Saline irrigated radiofrequency were performed in 25 patients with rheumatic valvular disease and chronic AF who unde,went valvular replacement during open heart operation. Amiodarone was given lasted for three months. Resluts There was no operative death. The RF ablation procedure lasted （15 ± 7）min, CPB time and duration of aortic cross - clamp time was （ 122 ± 50 ） min and （ 65 ± 17 ） rain. All the 25 patients recovered sinus rhythm immediately after the operation or after electrical cardioversion,2 patients turned to node rhythm in 24 hours,5 patients had an alternating sinus rhythm and atrial fibrillation in the first week and resumed normal sinus rhythm by use of amiodarone. All patients reached 6 to 48 months of followed - up, mean time was（27± 4） months,23 patients （92%）remained in sinus rhythm and 2 in node rhythm. Conclusions Saline irrigated radiofrequency modified maze procedure is safe, simple and effective, resulting in elimination of AF, and have an excellent long -term result.

关 键 词：心房颤动 风湿性心脏瓣膜病 射频消融 

分 类 号：R541[医药卫生—心血管疾病]