环肺静脉电隔离术的不同消融终点对房颤患者预后的影响  

Effect of different circumferential pulmonary vein ablation endpoints on prognosis of atrial fibrillation patients: bidirectional block between pulmonary veins and left atrium

作　　者：李曼[1] 钟敬泉[1] 岳欣[1] 朱清[1] 郑兆通[1] 荣冰[1] 衣少雷[1] 谢飞[1] 张运[1] 

机构地区：[1]山东大学齐鲁医院心内科,山东济南250012

出　　处：《山东大学学报（医学版）》2015年第3期62-68,共7页Journal of Shandong University:Health Sciences

基　　金：国家自然科学基金(81270238);高等学校博士学科点专项科研基金(博士生导师类;20130131110065);山东省科技发展计划(2012G0021850)

摘　　要：目的探讨环肺静脉(PVs)射频消融术的不同消融终点是否影响房颤(AF)患者的术后复发。方法选取137例伴有症状的AF患者(113例阵发性AF及24例持续性AF),经环PVs射频消融术实现PVs与左心房(LA)双向传导阻滞。术后均观察30 min,110例AF患者(92例阵发性AF及18例持续性AF)消融成功。根据不同消融终点,将92例阵发性AF患者分为两组:肺静脉电位消失组包括36例患者,肺静脉电位(PVPs)均消失;肺静脉电位延迟组包括56例患者,任一PVPs未消失,延迟时间大于30 ms。结果经过2年随访,肺静脉电位消失与延迟两组AF患者的复发情况无统计学差异(P=0.159)。结论与PVPs完全消失相比较,双向阻滞对阵发性房颤患者的生活质量及复发情况无明显影响。Objective To study the effect of different endpoints of ablation on the prognosis of atrial fibrillation（ AF）patients. Methods A total of 137 patients with symptomatic AF（ 113 paroxysmal AF and 24 persistent AF） underwent3 D mapping. Radiofrequency energy was released in one encircling line to the endpoint of bidirectional conduction block between the pulmonary veins（ PVs） and the left atrium（ LA）. After the postoperative observation with 30 minutes,isolation was successful in 110 AF patients（ 92 paroxysmal AF and 18 persistent AF）. The 92 paroxysmal AF patients were divided into two groups： one group included 36 patients in which all PVPs disappeared,and the other group included 56 patients in which at least one of pulmonary vein potentials（ PVPs） delayed by more than 30 ms. Results During two years follow-up,the recurrence of paroxysmal AF had no significant difference between the two groups（ P = 0. 159）. Conclusion Bidirectional block has no obvious effect on the living quality and recurrence of paroxysmal atrial fibrillation patients compared with those in which PVPs disappeared.

关 键 词：房颤 双向阻滞 肺静脉 心房 消融 

分 类 号：R541.7[医药卫生—心血管疾病]