慢性心房颤动患者消融术后左心房和左心室结构远期变化  

Long-term changes of left atrial and ventricular chamber’s structure after radiofrequency ablation in patients with chronic atrial fibrillation

作　　者：廖禄明[1] 吴书林[1] 鲁明军[1] 杨平珍[1] 詹贤章[1] 薛玉梅[1] 

机构地区：[1]广东省人民医院广东省医学科学院广东省心血管病研究所,广州510010

出　　处：《岭南心血管病杂志》2010年第3期190-192,198,共4页South China Journal of Cardiovascular Diseases

基　　金：广东省科技计划项目(项目编号:2008A030201030)

摘　　要：目的观察维持窦性心律(窦律)对慢性心房颤动(房颤)射频消融术后患者左心房和左心室结构的影响。方法入选38例慢性房颤行射频消融术的患者,分别于术前、术后1年行超声心动图检查,测量的超声心动图指标为左心房前后径、左心房上下径、左心房左右径、左心房最大容积、左心室舒张末内径、左心室收缩末内径,左心室射血分数,评估房颤有无复发对左心房及左心室重构的影响。结果 31例慢性房颤患者完成随访,随访时间为(13.45±1.46)个月,将其按消融效果分为复发组(15例)和非复发组(16例)。随访结果如下:(1)消融术前复发组与非复发组超声指标的基线资料比较,差异无统计学意义(P>0.05)。(2)复发组术后12个月左心房前后径、左心房上下径、左心房左右径、左心房最大容积、左心室舒张末内径、左心室收缩末内径、左心室射血分数与术前比较,差异无统计学意义(P>0.05);(3)非复发组消融术后12个月左心房前后径较术前减小[(38.73±3.77)mmvs.(41.86±4.73)mm,P<0.01],左心房上下径较术前减小[(58.03±4.31)mmvs.(61.70±3.80)mm,P<0.01],左心房左右径较术前减小[(43.93±6.06)mmvs.(46.08±6.62)mm,P<0.01],左心房最大容积较术前减小[(75.78±22.27)mLvs.(83.18±24.29)mL,P<0.01],左心室舒张末内径较术前减小[(45.85±4.98)mmvs.(48.26±5.36)mm,P<0.01]、左心室收缩末内径较术前减小[(28.74±4.27)mmvs.(31.44±5.32)mm,P<0.01],左心室射血分数较术前增加[68.03%±4.58%vs.62.75%±7.23%,P<0.01],差异有统计学意义。结论维持窦律能使射频消融术后12个月的慢性房颤患者左心房及左心室逆向重构,左心室收缩功能改善。Objectives To observe the long-term changes of the left atrial and ventricular chamber＇ s structure after radiofrequency catheter ablation in patients with chronic atrial fibrillation. Methods We selected 38 patients who underwent radiofrequency catheter ablation with chronic atrial fibrillation to take echocardiography before ablation and one-year after ablation respectively. The left atrial anteruposterior diameter, the left atrial diameter from top to bottom, the left atrial diameter in the medial-lateral, the left atrial maximum volume （LAVmax）, the left ventricular end- diastolic diameter （LVEDd）, the left ventricular end-systolic diameter （LVESd）, the left ventricular ejection fraction （LVEF）were measured to assessed the effects of left atrial and ventricular remodeling whether atrial fibrillation recurred. Results Thirty-one chronic atrial fibrillation patients completed the follow-up, the follow-up time was （13.45±1.46） months. According to the effects of ablation, the patients were divided into the recurrence group （15 patients） and the non-recurrence group （16 patients）. The results were as follows： 1. The baseline data of the left atrial and ventricular structure before ablation between the recurrence group and the non-recurrence group had no statistical significance （P〉 0.05）. 2.The difference of the left atrial anteroposterior diameter, the left atrial diameter from top to bottom, the left atrial diameter in the medial-lateral, LAVmax, LVEDd, LVESd, LVEF before ablation and 12 months after ablation in recurrence group had no statistical significance （P〉0.05）. 3.In non-recurrence group, after 12 months, left atrial anteroposterior diameter decreased compared with that before ablation [ （38.73±3.77）mm vs. （41.86±4.73） mm, P〈0.01 ] ,left atrial diameter from top to bottom decreased compared with that before ablation [ （58.03±4.31）mm vs. （61.70 ±3.80）mm,P〈0.01 ],left atrial diameter in the medial-lateral decreased compared with that bef

关 键 词：心房颤动 导管消融术 超声心动图 逆向重构 

分 类 号：R541.75[医药卫生—心血管疾病]