心内直视下Atricure双极射频消融治疗器质性心脏病合并心房颤动  

Atricure bipolar radiofrequency ablation for organic heart disease with atrial fibrillation under the open heart surgery

作　　者：刘胜中[1] 曾富春[1] 

机构地区：[1]四川省人民医院心胸外科,四川成都610072

出　　处：《四川医学》2009年第11期1716-1718,共3页Sichuan Medical Journal

摘　　要：目的评价器质性心脏病（OHD）合并心房颤动（AF）心内直视下Atricure双极射频消融（RFA）治疗的手术效果以及影响手术效果的相关因素。方法2007年8月～2008年11月29例OHD（27例风湿性心脏病、2例先天性心脏病）合并AF患者接受手术治疗,所有患者均在全麻低温体外循环心内直视下行心脏瓣膜置换及先心病矫治术,同期行Atricure双极RFA改良迷宫术。结果心脏复跳后全组29例患者均转为窦性心律（100%）,术后有10例复发房颤（34.48%）,给予可达龙治疗后均转为窦性心律。术后随访率为93.10%（27/29,2例住院期间死亡）,平均随访（6.8±1.4）个月,96.29%（26/27）维持窦性心律,3.71%（1/27）为AF心律。转窦组AF病史（21.3±34.4）个月,AF复发或者维持组为（84.7±40.9）个月,P〈0.01;转窦组左房内径为（51.6±12.7）mm,AF复发或者维持组为（68.5±13.4）mm,P〈0.05;转窦组心胸比率为55%～62%,AF复发或者维持组为59%～76%,P〈0.05。结论OHD合并AF术中同期行Atricure双极RFA治疗,术后长期窦性心律维持率高。RFA作为心脏手术的辅助手术具有安全、省时、治疗AF效果好等优点,值得临床推广应用。Objective To evaluate the clinical results and related factors of the Atricure bipolar radiofrequency ablation （RFA） for organic heart disease（OHD） with atrial fibrillation（AF） under the open heart surgery. Methods From August 2007 to November 2008,29 cases with OHD（27 cases of rheumatic heart disease and 2 cases of congenital heart disease ） were included. Patients were operated by genernal anesthesia,low-temperature and cardiopulmonary bypass, and the Atricuro bipolar RFA modified maze procedure was performed for patients with AF. Results All patients were sinus rhythm after the hearts beated again （ 100% ）. 10 cases recurrented AF after the cardiac surgery（34. 48% ） ,but returned to sinus rhythm with cordarone treatment. 27 cases were followed up（6. 8±1.4） months（93.10% ）. Sinus rhythm was 96. 29% （26/27）. AF was 3.71% （1/27）. The AF history of group keeping in AF was significantly bigger longer than group of sinus rhythm. Moreover,the left atrium diameter and cardiothoracic ratio were significantly bigger than group of sinus rhythm. Conclusion RFA was a safe,easy and valid treatment for OHD patients with AF. There were lower complications and high rate of restoring sinus rhythm.

关 键 词：射频消融 心房颤动 器质性心脏病 心脏手术 

分 类 号：R654.2[医药卫生—外科学]