射频消融治疗频发室性早搏对左室功能及其结构的影响  

Effect of radiofrequency catheter ablation on function and structure of left ventricle during treatment for frequent premature ventricular beats

作　　者：庄晓华[1] 桂燕萍[2] 牛晓萍[2] 张家友[2] 顾兴建[2] 赵亮[2] 徐涛[2] 廖德宁[2] 

机构地区：[1]上海市浦东新区南汇中心医院心血管内科,上海201300 [2]第二军医大学长征医院心血管内科,上海200003

出　　处：《第二军医大学学报》2012年第4期395-398,共4页Academic Journal of Second Military Medical University

摘　　要：目的探讨射频消融治疗频发室性早搏(室早)对左室功能及其结构的影响。方法收集2006年1月至2010年12月成功行射频消融治疗的频发室早患者56例,同期随访未予射频消融治疗的频发室早患者42例。比较两组患者不同处理前、后的室早数和超声心动图左室射血分数(LVEF)、左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)、室间隔厚度(IVSd)、左室后壁厚度(LVPWd)等各参数的变化。结果 (1)与非消融组比较,消融组射频消融治疗后室早总数明显减少[(125±113)个/24 h vs(17 813±1 542)个/24 h,P<0.01];超声心动图的各项参数[LVEDD(44.1±4.0)mm vs(48.9±3.8)mm;LVESD(27.0±3.7)mm vs(30.1±4.2)mm;IVSd(7.5±0.8)mm vs(8.5±0.8)mm;LVPWd(7.5±0.8)mm vs(8.5±0.9)mm;LVEF(0.72±0.06)vs(0.64±0.08)]组间差异均有统计学意义(P<0.05)。(2)与治疗前比较,射频消融治疗后室早总数减少[(125±113)个/24 h vs(23 662±12 559)个/24 h,P<0.01],患者胸闷、心悸症状缓解,超声心动图参数LVEDD[(44.1±4.0)mm vs(50.6±5.4)mm]、LVESD[(27.0±3.7)mm vs(32.1±5.3)mm]、IVSd[(7.5±0.8)mm vs(8.8±1.1)mm]、LVPWd[(7.5±0.8)mm vs(8.7±1.1)mm]明显减小(P<0.05);LVEF[(0.72±0.06)vs(0.64±0.09)]显著提高(P<0.05)。结论射频消融可有效改善频发室早引起的心脏结构重构和功能减退,缓解患者不适症状。Objective To investigate the effect of radiofrequency catheter ablation（RFCA） on the function and structure of left ventricle during treatment for frequent premature ventricular beats（PVBs）.Methods Totally 56 patients with PVBs,who had been successfully treated with RFCA from Jan.2006 to Dec.2010,were included in the present study（ablation group）.The other 42 patients with frequent PVBs,who received no RFCA treatment,served as controls（non-ablation group）.The changes of total number of PVBs,left ventricular ejection fraction（LVEF）,left ventricular end-diastolic diameter（LVEDD）,left ventricular end-systolic diameter（LVESD）,interventricular septal diameter（IVSd）,left ventricular posterior wall diameter（LVPWd） were observed before and after different treatments.Results（1）Compared with the non-ablation group,the ablation group had significantly reduced total number of PVBs（[125±113]/24 h vs [17 813±1 542]/24 h,P〈0.01）,increased LVEF（[0.72±0.06] vs [0.64±0.08],P〈0.05）,and significantly decreased LVEDD（[44.1±4.0] mm vs [48.9±3.8] mm）,LVESD（[27.0±3.7] mm vs [30.1±4.2] mm）,IVSd（[7.5±0.8] mm vs [8.5±0.8] mm）,and LVPWd（[7.5±0.8] mm vs [8.5±0.9] mm）（P〈0.05）.（2）Compared with the baseline levels,the total number of PVBs in the ablation group decreased from（23 662±12 559）/24 h before RFCA to（125±113）/24 h（P〈0.01） after RFCA,and patients had relieved chest tightness and heart palpitations.Meanwhile,the LVEF was significantly increased after RFCA（[0.72±0.06] vs [0.64±0.09],P〈0.05）;LVEDD（[44.1±4.0] mm vs [50.6±5.4] mm）,LVESD（[27.0±3.7] mm vs [32.1±5.3] mm）,IVSd（[7.5±0.8] mm vs [8.8±1.1] mm）,and LVPWd（[7.5±0.8] mm vs [8.7±1.1] mm） were significantly decreased after RCFA（P〈0.05）.Conclusion RFCA can effectively improve the structural remodeling and cardiac dysfunction induced by PVBs,relieving the patient symptoms.

关 键 词：频发室性早搏复合征 射频电流 导管消融术 

分 类 号：R541.7[医药卫生—心血管疾病]