射频消融房颤患者左室舒张功能不全对临床症状及术后复发的影响  

Effects of left ventricular diastolic dysfunction on clinical symptoms and recurrence of atrial fibrillation in AF patients treated by radiofrequency catheter ablation

作　　者：杜发旺[1] 李时乐[1] 徐延敏[1] 

机构地区：[1]天津医科大学第二医院心脏科,天津300211

出　　处：《中国慢性病预防与控制》2013年第3期309-311,共3页Chinese Journal of Prevention and Control of Chronic Diseases

摘　　要：目的探讨射频消融心房颤动(以下简称房颤,AF)患者左室舒张功能不全(LVDD)对临床症状严重程度及术后复发的影响。方法选取我院行环肺静脉消融术的阵发性AF和持续性AF的患者89例,依据欧洲心律学会AF相关症状分级(EHRA)对患者的临床症状进行分级。对患者进行随访,分析LVDD对AF患者临床症状严重程度及射频消融后复发的影响。结果入选的89例行射频消融术的患者中合并LVDD的AF患者42例。与未合并LVDD的患者比较,在年龄、高血压、使用β受体阻滞剂、二尖瓣E峰值流速/二尖瓣A峰值流速(E/A)比值方面,差异均有统计学意义(P<0.05,P<0.01)。LVDD组EHRA分级在Ⅲ、Ⅳ的患者共36例(85.8%)。将EHRA症状分级Ⅰ、Ⅱ级归类于无及轻度临床症状组(31例),Ⅲ、Ⅳ级患者归类于中、重度临床症状组(58例),对其一般临床资料进行比较发现,两组LVDD检出率(无及轻度症状组为19.4%,中、重度症状组为62.1%)差异有统计学意义(P<0.01),消融术后复发27例(30.3%),其中,合并LVDD的患者18例(42.9%),未合并LVDD的患者9例(19.1%),两组比较,差异有统计学意义(χ2=5.080,P<0.05)。结论伴有LVDD的AF患者临床症状重,射频消融术后复发率高。Objective To assess the role of left ventrieular diastolic dysfunction （LVDD） on clinical symptoms and recurrence of atrial fibrillation （AF） in AF patients treated by radiofrequency catheter ablation. Methods After 89 patients with paroxysmal or persistent AF were treated with radiofrequeney catheter ablation, the patients were followed up. The clinical symptoms were classified in AF patients according to the European Heart Rhythm Association score （EHRA）. The effects of LVDD on the clinical symptoms and recurrence of AF patients treated with radiofrequency catheter ablation were analyzed. Results in 89 AF patients treated with catheter ablation, LVDD appeared in 42 patients. As compared to patients without LVDD, there were significant differences of age, hypertension, use beta-blocker and E/A ratio （P〈0.05 or P〈0.01）. There were 36 cases （85.8%） with EHRA at Ⅲ and Ⅳ levels in patients with LVDD. In mild symptoms （EHRA at Ⅰ and Ⅱ levels） group there were 31 cases, and in moderate or severe symptoms （EHRA at Ⅲ and Ⅳ levels） group there were 58 cases. There were significant differences of clinical characteristics between two groups （P〈0.01）. After treatment with catheter ablation, AF recurrence occurred in 27 patients （30.3%）, in which there were 18 cases （AF recurrence rate： 42.9%） with LVDD and 9 cases （AF recurrence rate： 19.1%） without LVDD, the difference of AF recurrence rate was very significant （P〈0.01）. Conclusion There is severe clinical symptoms and high AF recurrence rate after treatment with catheter ablation in AF patients with LVDD.

关 键 词：心房颤动 左室舒张功能不全 症状分级 射频消融术 

分 类 号：R541[医药卫生—心血管疾病]