心房颤动导管射频消融肺静脉电隔离前后的抗凝治疗  

Anticoagulation therapy in patients with paroxysmal atrial fibrillation before and after the pulmonary vein isolation

作　　者：何鹏义[1] 木胡牙提[1] 马依彤[1] 张燕一[1] 

机构地区：[1]新疆医科大学第一附属医院心脏中心,新疆乌鲁木齐830011

出　　处：《新疆医科大学学报》2011年第8期794-797,共4页Journal of Xinjiang Medical University

基　　金：国家自然科学基金(81060017)

摘　　要：目的探讨心房颤动(简称房颤)导管射频消融肺静脉电隔离前后的抗凝治疗效果。方法对2006年3月～2009年4月108例经导管消融治疗房颤患者进行随访分析。患者术前行经食管心脏超声和/或螺旋CT心脏成像检查排除心房内血栓;对有高血压、糖尿病、短暂脑缺血或脑栓塞病史者或年龄>65岁的房颤患者术前华法林抗凝治疗1个月,术后华法林抗凝治疗3个月。结果 108例患者共接受肺静脉电隔离治疗116次(8例进行了第二次肺静脉电隔离术),隔离肺静脉348根。108例患者均未发生与手术相关的血栓栓塞事件。结论房颤患者在导管射频消融静脉电隔离手术前常规行经食管超声和/或螺旋CT检查排除心房血栓,并在手术前后及术中进行规范抗凝治疗,可有效预防手术相关血栓栓塞并发症。Objective To investigate the anticoagulation therapy in patients with paroxysmal atrial fibrillation before and after the pulmonary vein isolation.MethodsThe efficacy of anticoagulation therapy in patients with paroxysmal atrial fibrillation（PAF） who underwent pulmonary vein isolation were evaluated.Segmental pulmonary vein isolation was performed in 108 consecutive patients with symptomatic PAF,mean age 53.1±6.9 years.In the 108 patients,routine TEE and/or spiral CT examination were performed before ablation and warfarin was given for 1 month in patients with one of the following risk factors：hypertension,diabetes,a history of transient ischemic attack or stroke,and 65 years old.Anticoagulant was also administ rated in all the 108 patients after ablation for 3 months.ResultsThromboembolic event was not observed in any of the 108 patients.ConclusionThromboembolic event related to the pulmonary vein isolation procedure in patients with PAF could be prevented by routine TEE and/or spiral CT cardiac examination and anticoagulation using warfarin.

关 键 词：心血管病学 心房颤动 导管消融 射频电流 血栓栓塞 

分 类 号：R541.7[医药卫生—心血管疾病]