左心房内径大于60 mm心房颤动患者行改良迷宫射频消融术的疗效  

Clinical outcomes of bipolar radiofrequency ablation modified maze procedure for treating atrial fibrillation in patients with left atrial diameter more than 60 mm

作　　者：邓元子[1] 李韬[1] 胡楝[1] 刘超[1] 

机构地区：[1]广东省高州市人民医院心血管外科,高州525200

出　　处：《岭南心血管病杂志》2013年第5期594-597,共4页South China Journal of Cardiovascular Diseases

摘　　要：目的 评价改良迷宫双极射频消融术在左心房内径＞60 mm患者中治疗心房颤动（房颤）的临床疗效.方法 对同一术者在瓣膜置换同期行改良迷宫双极射频消融术并随访9个月以上的患者106例,按左心房内径大小分为两组：观察组左心房内径＞60 mm（27例）,对照组左心房内径＜60 mm（79例）.对所有患者进行随访分析,比较两组手术疗效.结果 两组手术并发症发生率比较,差异无统计学意义（P＞0.05）.观察组术后当日恢复窦性心律23例,心房扑动1例,房颤2例,交界性心律1例,房颤消除率为88.9％.出院时窦性心律22例,心房扑动2例,房颤消除率为88.9％.术后9～12个月窦性心律21例,房颤6例,房颤消除率为77.8％.对照组术后当日恢复窦性心律71例,心房扑动1例,房颤5例,交界性心律2例,房颤消除率为91.1％.术后9～12个月窦性心律70例,房颤9例,房颤消除率为88.6％.随访至术后9～12个月观察组房颤消除率与对照组相比,差异无统计学意义[77.8％（21/27）vs.88.6％（70/79）,P＞0.05].结论 左心房内径＞60 mm的患者行改良迷宫双极射频消融术治疗房颤安全、简便,仍可获得较好的近期疗效.对左心房显著增大的患者,增加左心房后壁消融线路,术后注意避免过高的中心静脉压、维持钾离子浓度在正常高值,有利于提高手术疗效.Objectives To evaluate the outcomes of bipolar radiofrequency ablation modified maze procedure for treating atrial fibrillation in patients with left atrial diameter more than 60 mm. Methods Totally 106 patients received bipolar radiofrequency ablation modified maze procedure in valve replacement were followed up for more than 9 months. They were divided into two groups： 27 patients （left atrial diameter more than 60 mm） were in observation group and 79 patients （left atrial diameter less than 60 mm） were in control group. Surgical outcomes during follow-up between the two groups were compared. Results There was no significant difference in surgical complications between observation group and control group （P〉0.05）. In observation group, 23 patients returned in sinus rhythm, 1 patient in atrial flutter, 2 patients in atrial fibrillation, 1 patient in junctional rhythm on the operation day （atrial fibrillation elimination coefficient was 88.9%）. There were 22 patients remained in sinus rhythm, 2 patients in atrial flutter at discharge （atrial fibrillation elimination coefficient was 88.9%）. In the follow-up of 9-12 months, 21 patients remained in sinus rhythm, 6 patients in atrial fibrillation （atrial fibrillation elimination coefficient was 77.8% ）. In control group, 71 patients returned in sinus rhythm, 1 patient in atrial flutter, 5 patients in atrial fibrillation, 2 patient in junctional rhythm on the operation day （atrial fibrillation elimination coefficient was 91.1% ）. In the follow-up of 9-12 months, 70 patients remained in sinus rhythm, 9 patients in atrial fibrillation （atrial fibrillation elimination coefficient was 88.6% ）. In the follow-up of 9-12 months,there was no significant difference in atrial fibrillation elimination coefficient between observation group and control group [77.8%（21/27）vs. 88.6%（70/79）,P〉0.05]. Conclusions Bipolar radiofrequency ablation modified maze procedure is a safe and simple method for treating atrial fibrillation in patients

关 键 词：心房颤动 改良迷宫手术 双极射频消融术 瓣膜置换 

分 类 号：R541.7[医药卫生—心血管疾病]