持续性心房颤动合并心力衰竭患者经射频导管消融后的心功能变化  

Changes in Cardiac Function in Patients with Persistent Arial Fibrillation and Heart Failure after Radiofrequency Catheter Ablation

作　　者：郑甲林[1] 陶四明[1] 李建美[1] 蒋晨阳[1] 魏巍[1] 杨志刚[1] 洪云飞[1] 张仪坚[1] 

机构地区：[1]云南省第二人民医院心内科、浙江大学医学院附属邵逸夫医院心内科,昆明市650021

出　　处：《心电学杂志》2011年第2期98-100,103,共4页Journal of Electrocardiology(China)

摘　　要：目的 评价持续性心房颤动合并心力衰竭患者经射频导管消融（下称＂消融＂）治疗后的心功能变化. 方法 23例持续性心房颤动合并心力衰竭患者接受消融治疗和抗心力衰竭药物治疗.随访12个月时有15例患者仍为窦性心律或阵发性心房颤动,比较该组患者术前、术后3个月和术后12个月的左心室射血分数（LVEF）、左心室舒张末期内径（LVEDd）、左心房内径（LAD）,X线胸片中心胸比例和6min步行距离. 结果 术后3个月与术前比较,LAD缩小而 LVEF增加（均P〈0.05＝,其他参数无明显变化（均P〉0.05）.术后12个月与术前及术后3个月比较,LVEF和6min步行距离增加（均P〈0.05＝,而LVEDd,LAD和心胸比例缩小（均P〈0.05）. 结论 持续性心房颤动合并心力衰竭患者经消融治疗后,长期维持窦性心律者心功能得到明显改善.Objective To assess changes in cardiac function in patients with persistent atrial fibrillation （AF） and heart failure after catheter ablation. Methods 23 patients with persistent AF and heart failure underwent ablation and received anti-heart failure medication. Of them, 15 cases had no AF relapsed or only paroxysmal AF occurrence during 12 months follow-up. Left ventricular ejection fraction （LVEF）, left ventricular end-diastolic diameter （LVEDd）, left atrial diameter （LAD）, cardiothoracic ratio（CTR） and 6-minute walk distance（6MWD） were measured before, 3 and 12 months after ablation, respectively, in this group. Results LVEF increased and LAD reduced significantly 3 months after ablation than before （all P〈0.05）. LVEF and 6MWD were significantly greater（all P〈0.05）, while LVEDd, LAD and CTR were significantly smaller 12 months after ablation than that before and 3 months after ablation （all P〈0.05）. Conclusion Cardiac function will improve significantly as sinus rhythm maintains over a long period of time after AF ablation in patients with persistent AF and heart failure.

关 键 词：心房颤动 心力衰竭 射频导管消融 

分 类 号：R541.75[医药卫生—心血管疾病]