导管射频消融术治疗心房颤动127例临床分析  

Clinical analysis of radiofrequency catheter ablation in treatment of 127 atrial fibrillation patients

作　　者：刘韵情 李铁军[1] 马淑梅[1] 张迪[1] 

机构地区：[1]中国医科大学附属盛京医院心内科,沈阳110004

出　　处：《中国医师进修杂志》2014年第34期23-25,共3页Chinese Journal of Postgraduates of Medicine

摘　　要：【摘要】目的探讨导管射频消融术治疗心房颤动的有效性、安全性及术后复发的相关因素。方法回顾性分析127例心房颤动患者的临床资料，在三维标测系统指导下行环肺静脉消融，观察患者手术远期成功率及有无不良反应，并分析心房颤动术后复发的相关因素。结果127例患者术后12个月进行随访，共94例患者保持窦性心律，33例患者复发，单次消融成功率为74．02％（94／127）。复发患者中11例接受再次消融并成功，两次消融成功率82．68％（105／127），其中持续性心房颤动成功率为56．52％（13／23），阵发性心房颤动成功率为88．46％（92／104）。单因素分析显示：心房颤动类型、左房内径、病程、早期复发、体质量指数与心房颤动导管射频消融术后复发相关。多因素Logistic回归分析显示心房颤动类型和左房内径是预测其术后复发的独立危险因素（P〈0．05）。结论导管射频消融术治疗心房颤动具有较好的临床疗效，心房颤动类型、左房内径是心房颤动导管射频消融术后复发的临床预测指标。Objective To investigate the clinical efficacy, safety and the correlation factors of recurrence of radiofrequency catheter ablation in treatment of atrial fibrillation. Methods The clinical data of 127 patients with atrial fibrillation having underwent circumferential pulmonary vein ablation guided by 3-D mapping system were analyzed retrospectively. Then they were followed up for 12 months. The status of patients after ablation and the success rate of ablation was recorded, then the relationship between the factors and the recurrence after ablation of atrial fibrillation was analyzed. Results After a follow up of 12 months, 94 patients maintained sinus rhythm, and atrial fibrillation recurred in 33 cases. The first clinical success rate was 74.02% （94/127）. Thirty-three patients with recurred atrial fibrillation received ablation again and 11 patients got success. The total clinical success rate was 82.68% （105/127）. The success rate of paroxysmal atrial fibrillation was 88.46% （92/104） and success rate of persistent atrial fibrillation was 56.52% （13/23）. Univariate analysis showed that the type, the course, the diameters of left atrial, the early recurrence, the body mass index were related to the recurrence of atrial fibrillation, and multivariable Logistic analysis revealed only the type and the diameters of left atrial were independent risk factors responsible for the recurrence of atrial fibrillation （P 〈 0.05 ）. Conclusion Radiofrequency catheter ablation in treatment of atrial fibrillation is effective and safe, and the type and the diameters of left atrial are independent risk factors responsible for the recurrence of atrial fibrillation.

关 键 词：心房颤动 导管消融术 复发 

分 类 号：R541.7[医药卫生—心血管疾病]