导管射频消融术对房颤患者左心房结构的影响  

Evaluation of left atrial structure change after catheter ablation for atrial fibrillation

作　　者：唐红 冯媛媛[2] 舒茂琴[3] 

机构地区：[1]重庆市沙坪坝区中医院内科,400030 [2]解放军第401医院干部科,山东青岛266071 [3]第三军医大学西南医院心内科,重庆400038

出　　处：《重庆医学》2011年第21期2135-2136,共2页Chongqing medicine

摘　　要：目的评价导管射频消融术对心房颤动（AF,房颤）患者左心房结构的影响。方法 43例房颤患者接受治疗,其中阵发性房颤32例,持续性房颤11例。8例行肺静脉电隔离术,35例行Carto指导下环肺静脉前庭隔离术,消融终点均为双侧肺静脉完全电隔离。应用超声心动图测定其消融术前1-3 d和术后1、3个月静息时窦性心律下左心房内径,分析消融术前、后左心房结构的变化。结果 43例房颤患者均成功施行环肺静脉左房线性消融术,随访时间（6±2）月,最短3个月,最长14个月,治愈率93.02%。左房内径消融术后1个月较术前无明显改变[（35.74±5.77）mm vs（35.69±6.25）mm,P〉0.05],随访3个月时左房内径较术前显著减小[（31.99±3.66）mm vs（35.69±6.25）mm,P〈0.01]。结论房颤患者于术后3个月时左房结构可逆重构。Objective To evaluate the left atrial structure change after radiofrequence catheter ablation（CA）for atrial fibrillation（AF）.Methods 43 patients were enrolled,AF was paroxysmal in 32 patients,and persistent in 11 patients.Pulmonary vein isolation（PVI）was performed for earlier 8 patients;Electroanatomical systems（Carto）guided circumferential pulmonary veins antrum ablation（CPVA）was performed for the other 35 patients.All patients were successfully achieved the endpoint of ablation.Conventional echocardiography was performed 1-3 days before CA and 1,3 months after CA.Echocardiographic parameters about left atrial（LA）diameter was measured at rest during sinus rhythm and the left atrial structure change was analyzed before and after the CA.Results CA was successfully performed in all 43 patients,and all these patients were followed-up after 3-14 months,average 6±2 months,and the cure rate was 93.02%.Compared with the 1-3 days pre-CA,LA diameter had no significant differences after 1 month CA[（35.74±5.77）mm vs（35.69±6.25）mm,P〈0.05],while significantly decreased after 3-months follow-up（（31.99±3.66）mm vs（35.69±6.25）mm,P〈0.01].Conclusion 3-months follow-up has demonstrated anti-remodeling of LA structure after CA for atrial fibrillation.

关 键 词：电生理学技术 心房颤动 导管射频消融术 左心房结构 

分 类 号：R541.7[医药卫生—心血管疾病]