环肺静脉电隔离对阵发性心房颤动患者左房功能的影响  

Effect of circumferential pulmonary vein ablation for paroxysmal atrial fibrillation on left atrial function

作　　者：郭飞[1] 汤宝鹏[1] 张燕一[1] 周贤惠[1] 朱建兵[1] 张疆华[1] 韩伟[1] 马依彤[1] 

机构地区：[1]新疆医科大学第一附属医院心脏中心起搏与电生理科,新疆乌鲁木齐830054

出　　处：《中国心脏起搏与心电生理杂志》2010年第3期234-237,共4页Chinese Journal of Cardiac Pacing and Electrophysiology

基　　金：国家自然科学基金资助项目(项目编号:308660299)

摘　　要：目的应用超声心动图技术评价环肺静脉电隔离术(CPVA)对阵发性心房颤动(PAF)患者左房功能的影响。方法 PAF患者81例,择期行CPVA,据术后PAF有无复发分为成功组及复发组;应用超声心动图测定术前及术后3天、3个月、12个月时静息状态下左房主动排空容积(LAAEV)、左房主动排空分数(LAAEF)、左房最大容积(LAVmax)、左房总排空容积(LATEV)、左房总排空分数(LATEF)、二尖瓣血流频谱A峰峰值流速(VA)、A峰速度时间积分(A-VTI)及左房射血力(LAEF)。结果成功组,术后3个月与术前比较,反应左房辅助泵功能的指标LAAEV、VA、A-VTI及LAEF均减少(P<0.05);术后12个月与术前比较,LAAEV、VA、A-VTI及LAEF均增加(P<0.05),反映左房储存功能的指标LAVmax、LATEV及LATEF均增加(P<0.05)。复发组,术后12个月与术前比较,LAAEV、VA、A-VTI及LAEF均减少(P<0.05)。结论 CPVA对PAF患者术后近期左房功能有不利影响,而术后远期功能得到明显改善。Objective To evaluate the effects of circumferential pulmonary vein ablation（CPVA） with the application of echocardiography for paroxysmal atrial fibrillation（PAF） patients on left atrial（LA） function. Methods Eighty one PAF patients underwent CPVA, and all the patients were didived into two groups according to the recurrence of AF;before ablation, echocardiography parameters including LA active emptying volume（ LAAEV）, LA active emptying fraction（ LAAEF）, LA maximum volume（ LAVmax）, LA total emptying volume（ LATEV）, LA total emptying fraction （ LATEF）, A peak velocity time intergral（A-VTI） and LA ejection force（LAEF） were measured;three days, three months and twelve months after ablation,those parameters were measured again. Results Group of unrecurrence,Compared with preablation,the changes of LA pump function such as LAAEV, VA,A-VTI and LAEF decreased significantly three months after ablation （P 〈 0.05 ） ; LAAEV, VA, A-VTI and LAEF increased significantly twelve months after ablation（ P 〈 0.05 ）, and the indicator of LA reservoir function such as LAVmax, LATEV and LATEF increased significantly twelve months after ablation （P 〈 0.05 ）. group of , Compared with preablation,LAAEV, VA,A-VTI and LAEF decreased significantly twelve months after ablation （P 〈 0.05）. Conclusion CPVA has negative impact on the LA function in the short-term following time future, but it has good impact on LA function in long-term future.

关 键 词：心血管病学 心房颤动 环肺静脉电隔离术 左房功能 超声心动图 

分 类 号：R541.75[医药卫生—心血管疾病] R454.1[医药卫生—内科学]