环肺静脉前庭隔离消融术与7字线消融术治疗心房颤动的对比研究  

Comparison of Circumferential Pulmonary Vein Antecourt Isolation Ablation and Stepwise Linear Ablation for Treating the Patients With Atrial Fibrillation

作　　者：马凌[1] 王菲[1] 蔡晓庆[1] 张玉秀[1] 史亮[1] 剡冬冬 姚焰[2] 张卫泽[1] 

机构地区：[1]兰州军区兰州总医院心血管内科,甘肃省兰州市730050 [2]中国医学科学院北京协和医学院心血管病研究所阜外心血管病医院

出　　处：《中国循环杂志》2014年第10期787-790,共4页Chinese Circulation Journal

摘　　要：目的:比较环肺静脉前庭隔离消融术与7字线消融术两种不同术式治疗心房颤动(房颤)的有效性和安全性。方法:对我科在EnSite三维指导下行房颤导管消融治疗的136例患者(阵发性房颤组93例,持续性房颤组43例)进行回顾性分析,按照其房颤类型和消融术式分为阵发性房颤环肺静脉前庭隔离消融者(45例),阵发性房颤7字线消融者(48例),持续性房颤环肺静脉前庭隔离消融者(18例),持续性房颤7字线消融者(25例),比较两术式对患者左心房直径、消融成功率、并发症情况、消融时间和X线曝光时间等因素的影响。结果:通过12个月的随访,两术式在治疗阵发性房颤组和持续性房颤组的成功率和并发症上均无显著统计学差异。对于阵发性房颤组,两术式均能有效减小左心房直径(P<0.01)。在手术时间上,7字线消融者明显短于环肺静脉前庭隔离消融者时间(P<0.01),但两术式X线曝光时间未见明显差异。结论:在房颤治疗中,环肺静脉前庭隔离消融者与7字线消融者均具有较高的有效性与较好的安全性,能有效逆转阵发性房颤中左心房重构。Objective： To compare the efifcacy and safety of circumferential pulmonary vein antecourt isolation （CPVAI） ablation and stepwise linear （SL） ablation in treating the patients with atrial ifbrillation （AF） Methods： A total of 136 AF patients with catheter ablation under EnSite 3000 guidance in our hospital were retrospectively summarized. The patients included 93 paroxysmal AF and 43 persistent AF and divided into 4 groups. Paroxysmal AF with CPVAI ablation,n=45, Paroxysmal AF with SL ablation,n=48 and persistent AF with CPVAI ablation, n=18, persistent AF with SL ablation,n=25. The differences of left atrium diameter, ablation time, X-ray exposure time, the success rate and complication were compared among different groups. Results： For 12 months follow-up study, the success rate and complication were similar between 2 ablation methods for treating both Paroxysmal AF and persistent AF patients. For Paroxysmal AF patients, both ablation methods could effectively reduce left atrium diameter,P〈0.01. The SL ablation had less procedural time than CPVAI ablation,P〈0.01, while the X-ray exposure time was similar between 2 ablation methods. Conclusion： Both CPVAI and SL ablation methods were effective and safe for treating AF patients.

关 键 词：心房颤动 环肺静脉前庭隔离消融 7字线消融 

分 类 号：R541[医药卫生—心血管疾病]