导管射频消融治疗阵发性心房颤动两种术式疗效对比  

Comparison of different catheter radiofrequency ablation strategies for patients with paroxysmal atrial fibrillation

作　　者：林刚[1] 黄建飞[1] 施林生[1] 徐云[1] 管耘园[1] 

机构地区：[1]江苏省南通市第一人民医院心内科,226001

出　　处：《中国医师进修杂志（内科版）》2009年第4期22-24,共3页Chinese Journal of Postgraduates of Medicine

摘　　要：目的比较节段性肺静脉电隔离术（SPVI）和环肺静脉前庭电隔离术（CPVA）对阵发性心房颤动射频消融治疗的临床疗效。方法选取68例行导管射频消融治疗的阵发性心房颤动患者，根据所采用的术式分为SPVI组（30例）和CPVA组（38例），比较两组手术时间、X线暴露时间及复发率。结果CPVA组手术时间为（171．0±25．8）min，SPVI组为（168．2±21．7）min，两组比较差异无统计学意义（P：0．579）。CPVA组x线暴露时间为（38．5±8．4）min，SPVI组为（45．8±16．1）min，两组比较差异有统计学意义（P=0．019）。所有病例平均随访（17．1±7．8）个月，CPVA组复发率为5．3％，SPVI组为233％，两组比较差异有统计学意义（P=0．029）。两组均未发生严重并发症。结论导管射频消融治疗阵发性心房颤动，CPVA比SPVI具有更少的X线暴露时间和更低的复发率，且不增加手术时间和手术风险。Objective To compare the clinical outcomes of segmental pulmonary veins isolation （ SPVI ） and circumferential pulmonary veins ablation （ CPVA ） for patients with paroxysmal atrial fibrillation.Methods Sixty-eight patients with paroxysmal atrial fibrillation from January 2004 to April 2008 were divided into SPVI group （30 cases） and CPVA group （38 cases）.The mean procedure time,the mean fluoroscopy time and relapse rate were compared. Results The mean procedure time in CPVA and SPVI group had no significant difference [ （ 171.0 ± 25.8 ） rain vs （ 168.2 ± 21.7） min, P = 0.579], but the mean fluoroscopy time in CPVA group [（38.5 ± 8.4） min]was less than that in SPVI group [（45.8 ± 16.1 ） mini （P= 0.019）. Mean term of the follow up was （ 17.1 ± 7.8） months. Relapse rate in CPVA group was less than that in SPVI group （5.3% vs 23.3%, P = 0.029 ）. Both groups had no severe complications. Conclusion In patients with paroxysmal atrial fibrillation, CPVA strategy provides a more favourable clinical outcomes and less fluoroscopy time.

关 键 词：心房颤动 导管消融术 肺静脉 

分 类 号：R541.7[医药卫生—心血管疾病] R541.75[医药卫生—内科学]