持续性房颤电复律后射频消融术成功率及术后短期复发率的研究  

The study of the success rate for persistence AF in the radiofrequency ablation after the electrical cardioversion and the postoperate recurrence rate

作　　者：谢力民[1] 于运福[1] 杨鹏伟[1] 陈小贞[1] 孙玉梅[1] 李文[1] 闫继锋[1] 

机构地区：[1]河南省胸科医院心血管内科,河南省郑州市450003

出　　处：《中国心血管病研究》2015年第10期917-920,共4页Chinese Journal of Cardiovascular Research

摘　　要：目的 通过比较持续性房颤经同步直流电复律成功后再行射频消融术治疗与直接行射频消融术治疗的术中直接复律率及术后短期复发率,探索更适宜接受射频消融术治疗的持续性房颤人群特点.方法 回顾分析2011年9月至2014年1月在我院行房颤射频消融术的54例持续性房颤患者资料,根据术前是否经同步直流电复律为窦性心律且维持窦性心律维持超过3个月,分为两组.A组16例,术前经同步直流电复律为窦性心律并维持窦性心律维持超过3个月后再发房颤,接受射频消融术治疗;B组38例,未经同步直流电复律,直接射频消融术治疗.比较两组术中射频消融直接恢复窦性心律比率及术后6个月房颤复发率.结果 术中直接复律率A组高于B组（56.2％比26.3％,P=0.035）,6个月复发率A组低于B组（18.8％比47.3％,P=0.045）.结论 非瓣膜性心脏病、左房≤50 mm、心功能无严重减退的持续性房颤患者经同步直流电复律后可较长时间维持窦性心律者,接受射频消融术治疗成功率较高,早期复发率低.Objective By studying the direct cardioversion effects on persistent AF between the radiofre- quency ablation after the successful electrical carioversion and the direct radiofrequency ablation to explore the characteristics of patients who are more suitable for radiofrequency ablation. Methods A retrospective analysis was made on the 54 cases of persistent AF with radiofrequency ablation in our college from September 2011 to January 2014. The 54 cases were divided into 2 groups based on whether were treated with preoperative synchronized direct current cardioversion for the sinus rhythm that lasts for over 3 months before the recurrence. Group A： 16 cases were treated with preoperative synchronized direct current cardioversion for the sinus rhythm that lasts for over 3 months before the recurrence, and then were treated with radiofrequency ablation. Group B： 38 cases were directly treated with radiofrequency ablation without electrical cardioversion. Compare the rate of intraoperative direct sinus rhythm restoration with radiofrequency ablation and the postoperative recurrence rate after 6 months. Results The rate of intraoperative direct cardioversion in Group A was higher than that in Group B （56.2% vs 26.3%, P= 0.035）, the rate of recurrence in Group A was lower than that in Group B（ 18.8% vs 47.3%, P=0.045）. Conclusion The success rates are high for those no Valvular heart disease, left atrial 50 mm or less, heart function without serious impairment of patients with persistent AF, who are treated with electrical cardioversion first and maintain a long-term sinus rhythm, and then are treated with radiofrequency ablation. Meanwhile, the recurrence rates are low for initial stages.

关 键 词：持续性房颤 同步直流电复律 射频消融术 

分 类 号：R541.6[医药卫生—心血管疾病]