上腔静脉电隔离在环肺静脉电隔离治疗阵发性心房颤动中的作用  

The effect of superior vena cava isolation in patients with paroxysmal atrial fibrillation undergoing circumferential pulmonary vein isolation

作　　者：张其银 张优[1] 林佳[1] 刘玉平[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血管内科,江苏苏州215006

出　　处：《中国心脏起搏与心电生理杂志》2016年第2期111-115,共5页Chinese Journal of Cardiac Pacing and Electrophysiology

摘　　要：目的探讨上腔静脉电隔离(SVCI)在环肺静脉电隔离(CPVI)治疗阵发性心房颤动(PAF)的作用。方法回顾分析导管射频消融(RFCA)的PAF患者103例,依据电生理检查及RFCA的结果分为:单纯CPVI组和CPVI+SVCI组,随访1年以上,观察AF复发率及并发症情况。结果入选103例患者共消融120人次,其中11例消融2次,3例消融3次。综合电生理检查及RFCA结果进行分组:单纯CPVI组88例、CPVI+SVCI组15例。随访期间,共计81例成功,累积成功率78.6%;CPVI+SVCI组13例成功,累积成功率86.7%;单纯CPVI组68例成功,累积成功率77.3%。CPVI+SVCI组术后有1例患者出现膈神经损伤,术后3个月未恢复。结论 SVC是常见的AF触发灶之一,SVCI有助提高行CPVI的PAF患者的消融成功率。Objective To evaluate the effect of superior vena cava isolation（SVCI） in patients with paroxysmal atrial fibrillation（PAF） undergoing circumferential pulmonary vein isolation（CPVI）. Methods In this study, 103 patients with PAF for RFCA were analyzed. They were divided into two groups by the results of electrophysiologi- cal examination and radiofrequency catheter ablation （RFCA） .. the group of CPVI,and the group of CPVI combined with SVCI. At an average of 12 months follow-up, observe the rate of atrial fibrillation（AF） recurrence and compli- cations. Results One hundred and three patients were underwent RFCA 120 times in all, while 11 patients were underwent 2 times, 3 patients were underwent 3 times. They were divided into two groups by the results of electrophysiological examination and RFCA; CPVI were underwent in 88 patients, and CPVI combined with-SVCI were underwent in 15 patients. At an average of one year follow-up, a total of 81 cases succeeded, the rate of success was 78.6%; 13 cases in CPVI combined with SVCI succeeded, the rate of success was 86.7%% 68 cases succeeded in CPVI group, the success rate was 77.3%. There was only one patient with phrenic nerve injury after RFCA in CP- VI combined with SCVI group, who recovered 3 months later. Conclusion Superior vena cava is one common cause of PAF, SVCI can improve the success rate of AF radiofrequency ablation in the patients undergoing CPVI. [Chinese Journal of Cardiac Pacing and Electrophysiology ,2016,30（2） ：111-115]

关 键 词：心血管病学 环肺静脉电隔离 上腔静脉隔离 阵发性心房颤动 导管消融 射频电流 

分 类 号：R541.75[医药卫生—心血管疾病] R454.1[医药卫生—内科学]