预激综合征患者发生心房颤动的危险因素及射频导管消融房室旁路后的远期预后  

The risk factors of atrial fibrillation in patients with Wolff-Parkinson-White syndrome and radiofrequency catheter ablation

作　　者：包萍[1] 王祖禄[1] 梁延春[1] 梁明[1] 韩雅玲[1] 刘艳霞[1] 

机构地区：[1]沈阳军区总医院心内科,110016

出　　处：《中华心律失常学杂志》2011年第4期259-263,共5页Chinese Journal of Cardiac Arrhythmias

基　　金：辽宁省自然科学基金（20102247）;沈阳军区总医院医学科研基金（09y-z01）

摘　　要：目的分析预激综合征伴心房颤动（房颤）患者的危险因素，研究射频导管消融房室旁路对房颤复发的影响。方法639例行射频消融术的预激综合征患者，对可能发生房颤的危险因素和消融房室旁路后房颤复发的影响因素进行分析。结果82例（12．8％）有房颤，557例无房颤。预激综合征伴房颤组男性、高龄、多旁路者更多。对成功消融房室旁路的预激综合征伴房颤患者80例进行随访，成功随访57例（随访率71．3％），其中6例（10．5％）房颤复发。消融后复发房颤组女性和高龄者多见，多伴有心脏相关性疾病，消融前房颤病史更长，左心房内径更大。结论男性、高龄、多旁路是预激综合征患者发生房颤的危险因素；而女性、高龄、基础心脏病、房颤病史长及消融前左心房内径大是预测消融后房颤复发的较好指标。Objective To analyze the risk factors of atrial fibrillation（AF） in patients with Wolit-Par- kinson-White （WPW） syndrome and to explore the possible predictors of AF recurrence after successful ablation. Methods The study population consisted of 639 patients with WPW syndrome underwent radiofrequency catheter ablation. Multiple factors were analyzed to define the risk factors of AF and the predictors for AF recurrence. Results Eighty-two patients （12. 8% ） had documented ECG of AF. Compared to the patients without AF,there were more men, older, and higher incidence of multiple accessory pathways in patients with AF. In the patients with AF,57 patients were successfully followed up. Six of the 57 patients （ 10. 5% ） had documented ECG of AF. The possible predictors for AF recurrence were examined. There were more women, older,in patients with recurred AF and more of them were associated with cardiac diseases ,larger size of left atrium. Conclusion Male, older age, and multiple accessory pathways are the risk factors of AF in patients with WPW Syndrome. Radiofrequency catheter ablation of accessory pathway can cure WPW syndrome and AF spontaneously in most patients during a long period of follow-up. Female, older age, associated cardiac diseases ,longer duration of AF history and larger left atrial diameter may be predictors for the recurrence of AF.

关 键 词：预激综合征 心房颤动 危险因素 射频导管消融 随访 

分 类 号：R541.7[医药卫生—心血管疾病]