左房容积与心房颤动导管消融术后患者复发的关系  

Relationship between left atrial volume calculated by multi-detector computed tomography and the atrial fibrillation recurrence after catheter ablation

作　　者：陈银蓉[1,2] 黄卫斌[1,2] 肖国胜[1,2] 陈超[1,2] 周法光[1,2] 曾昭萍[1,2] 温红梅[1,2] 王焱[1,2] 

机构地区：[1]福建医科大学教学医院 [2]厦门大学附属中山医院心内科厦门心脏中心,福建厦门361004

出　　处：《中国心脏起搏与心电生理杂志》2010年第6期524-526,共3页Chinese Journal of Cardiac Pacing and Electrophysiology

摘　　要：目的探讨左房容积（IAV）与心房颤动（简称房颤）消融术后房颤复发的相关性。方法104例房颤患者。术前应用64排容积CT扫描，在advantage workstation4．2图像工作站中重建左房，测量LAV，术中通过三维标测系统（CARTO）指导行射频消融术，术后3个月评定治疗效果，并随访6个月。结果随访6个月结束，t04例中有20例（19％）房颤复发。单因素分析结果显示，复发组平均IAV比未复发组的大[117．6±28．9cm^3，95％可信区间（CI）104．1～131．1cm^3 vs97．1±16．8cm^3，95％CI93．5～100．8cm^3，P=0．006]。多因素分析显示LAV是独立的预测导管}肖融术后复发的指标（P〈0．05，相对风险度=1．044，95％CI 1．018～1．071）。结论房颤射频消融术后房颤复发与LAV大小相关。Objective To investigate whether left atrial volume （LAV）, evaluated by muhi-detector computed tomography（MDCT） prior to ablation, will predict atrial fibrillation（AF） recurrence following catheter ablation. Methods One hundred and four patients （mean age 56.8 -8.9 years,67% male） with symptomatic AF were studied. All patients were submitted to 64-slice MDCT scan for LAV. The success of pulmonary vein isolation procedure was guided by CARTO Merge electroanatomical mapping. All patients were followed up in out-patient clinic for six months. Clinical success was assessed after 3-month blanking period. Results At the end of follow-up period, 20 patients（ 19% ） suffered from recurrent AF. Univariate analysis showed that the mean LAV of the recurrent group of patients was bigger than that of the non-recurrent group of patients（ 117.6 ±28.9 cm3 95% CI 104.1 - 131, 1 cm3 vs 97.1 ± 16.8 cm3 ,95% CI 93.5 - 100.8 cm3 ,P = 0.006 ）. Muhivariable analysis revealed that LAV was an independent risk factor responsible for the recurrence of AF （RR=1.044,95% CI1.018-1.071,P=0.017）. Conclusion LAV estimated by MDCT is an independent predictor of AF recurrence after catheter ablation.

关 键 词：心血管病学 心房颤动 导管消融 射频电流 左房容积 

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