左侧股静脉入路行心房颤动射频消融的可行性研究  

Feasibility study of atrial fibrillation radiofrequency catheter ablation with left femoral vein approach

作　　者：邸成业[1] 万征[2] 高鹏[1] 林文华[1] DI Cheng-ye;WAN Zheng;GAO Peng;LIN Wen-hua(Department of 1st Cardiology , TEDA International CardiovascularHospital , Tianjin 300457, China;Cardiovascular Center , Tianjin Medical University , Tianjin 300052, China)

机构地区：[1]泰达国际心血管病医院心内一科,天津300457 [2]天津医科大学总医院心血管病中心,天津300052

出　　处：《中国心脏起搏与心电生理杂志》2018年第6期551-553,共3页Chinese Journal of Cardiac Pacing and Electrophysiology

摘　　要：目的探讨经左侧股静脉入路行心房颤动(简称房颤)射频消融的可行性。方法入选阵发性房颤患者130例,分别经双侧股静脉穿刺房间隔各一次,比较经双侧穿刺针的塑形弯度,穿刺房间隔所需时间。按入路不同随机分为两组:经右侧股静脉送消融导管至左房,经左侧股静脉入路送肺静脉标测电极至左房(A组,n=67);经右侧股静脉送肺静脉标测电极至左房,经左侧股静脉送消融导管至左房(B组,n=63)行房颤射频消融,观察两组患者X线总曝光时间,消融时间有无差别。结果两组患者临床资料的比较无差别。经双侧股静脉穿刺房间隔时穿刺针的塑形弯度相同,成功穿刺房间隔所需时间无差别[(51.85±15.14)s vs(55.71±10.66)s,P=0.097]。两组患者X线总曝光时间[(3.27±1.13)min vs(3.58±0.92)min,P=0.082],消融时间[(57.90±12.23)min vs(54.81±9.18)min,P=0.108]无差别,两组患者均未发生心包积液、股动静脉瘘和股动脉假性动脉瘤等并发症。结论经左侧股静脉行房颤射频消融安全可行。Objective To investigate the feasibility of radiofrequency catheter ablation of atrial fibrillation ( AF )via left femoral vein approach. Methods One hundred and thirty patients with paroxysmal AF underwent radiofre -quency ablation in this study.The atrial septum was punctured bybilateral femoral vein , the needle shaped curve ,the difference for the time required to successfully puncture the atrial septum , were compared between the bilateralfemoral vein approach.The patients were divided into two groups according to different femoral vein approach : theablation catheter was advanced into the left atrium via the right femoral vein , the mapping catheter was advanced in -to the left atrium via the left femoral vein ( Group A , n =67 ); the ablation catheter was advanced into the left atriumvia the left femoral vein , the mapping catheter was advanced into the left atrium via the right femoral vein ( Group B ,n =63 ) .The total X -rayexposure time and ablation time between the two groups were observed. Results Therewere no significant difference between the two groups in the clinical data.There were no significant difference forneedle shaped curve , in the time required to successfully puncture the atrial septum [( 51. 85±15. 14 ) s vs ( 55. 71±10. 66 ) s , P =0. 097 ] between the two groups.There were no significant difference between the two groups X -rayto -tal exposure time [( 3. 27±1. 13 ) min vs ( 3. 58±0. 92 ) min , P =0. 082 ] and ablation time [( 57. 90±12. 23 ) min vs ( 54.81±9. 18 ) min , P =0. 108 ] of the two groups.There were no complications such as pericardial effusion , femoral ar -teriovenous fistula and femoral pseudoaneurysm in the two groups. Conclusions AF radiofrequency catheter abla -tion via the left femoral vein approach is safe and feasible.

关 键 词：心血管病学 心房颤动 股静脉 射频消融 并发症 

分 类 号：R541.75[医药卫生—心血管疾病] R454.1[医药卫生—内科学]