导管射频消融治疗阵发性心房颤动伴快-慢综合征的疗效分析  

Effect of radiofrequency catheter ablation on paroxysmal atrial fibrillation combined with tachy-brady syndrome in patients

作　　者：张其银 张优[1] 张宇桢 张方芳[1] 邹操[1] 陈弹[1] 惠杰[1] 

机构地区：[1]苏州大学附属第一医院心内科,江苏苏州215006

出　　处：《临床心血管病杂志》2016年第4期355-358,共4页Journal of Clinical Cardiology

摘　　要：目的:观察导管射频消融(RFCA)治疗阵发性心房颤动(PAF)伴快-慢综合征(TBS)的疗效。方法:回顾性分析行RFCA治疗的PAF患者118例,依据术前24h动态心电图(Holter)结果分为3组:PAF伴TBS为第1组(16例);PAF伴窦房结功能不良(SND)但不伴TBS为第2组(12例);单纯PAF为第3组(90例)。比较术后各组的房颤(AF)复发率、起搏器(PM)植入率、术前及术后3个月的Holter中的最长RR间期(MRRI)值。结果:平均随访12个月,第1组的AF复发率和PM植入率与第3组无差异(P>0.05);第2组在AF复发率和PM植入率上均显著高于第1组(P<0.05)和第3组(P<0.05)。第1组术前的MRRI(MRRI0)显著高于第2、3组(P<0.05);第1组术后3个月的MRRI(MRRI3)与第3组相比无统计学差异(P>0.05)。结论:PAF伴TBS患者,无论是否合并SND,均可选择行RFCA;而PAF伴SND,但不伴TBS的患者,应首选PM植入加药物治疗。Objective：To observe the effect of radiofrequency ablation（RFCA）for the patients of paroxysmal atrial fibrillation（PAF）combined with tachy-brady syndrome（TBS）.Method：In this study,118 patients with PAF for RFCA were analyzed.They were divided into three groups on the basis of 24-hour dynamic electrocardiogram（Holter）.Those with PAF and TBS were in group 1（16patients）.Those with PAF and sinus node dysfunction（SND）but without TBS were in group 2（12patients）,and the remainder were in group 3（90patients）.At an average of 12 months follow-up,observe the AF recurrence rate,the pacemaker（PM）implantation rate,and record the max RR interphase（MRRI）value in the holter of pre-RFCA and 3months after RFCA.Result：There were no differences in the rate of AF recurrence and PM insertion between group 1and group 3（P〈0.05）.The rate of AF recurrence and PM insertion in group 2is higher than group 1（P〈0.05）and group 3（P〈0.05）.MRRI before RFCA（MRRI0）in group 1was significantly higher than group 2and group 3（P〈0.05）.But 3months after RFCA,MRRI（MRRI3）have no difference between group 1 and group 3（P〈0.05）.Conclusion：Patients with PAF and TBS,whether with SND or not,can choose RFCA.Those patients with PAF and SND,but not with TBS,should be the preferred PM implantation plus drug treatment.

关 键 词：心房颤动 快-慢综合征 窦房结功能不良 导管射频消融 

分 类 号：R541.7[医药卫生—心血管疾病]