左房低电压区前壁线消融与二尖瓣峡部线消融治疗持续性房颤疗效比较  

Comparison on the Left Atrial Anterior Wall Ablation Through Low-voltage Area Versus Left Lateral Mitral Isthmus Ablation in Patients With Persistent Atrial Fibrillation

作　　者：郑武扬[1] 李卫华[1] 谢强[1] 万晓群[1] 黄峥嵘[1] 张紫冠[1] 

机构地区：[1]厦门大学附属第一医院心内科,福建厦门361003

出　　处：《中国卫生标准管理》2016年第21期73-76,共4页China Health Standard Management

基　　金：2012年福建省卫生厅青年科研课题资助(项目编号:2012-2-80)

摘　　要：目的探讨左心房低电压区行前壁线消融与二尖瓣峡部线消融对持续性房颤的疗效及安全性。方法入选2012年8月1日~2013年9月30日首次我院行射频消融的持续性房颤60例,随机分成两组,一组完成肺静脉隔离和房顶线消融后,电复律并行左心房高密度标测,在左房低电压区行左房前壁（left atrial anterior wall,LAAW）消融（LAAW组）;另一组完成肺静脉隔离和房顶线消融后,电复律并行二尖瓣峡部线（left lateral mitral isthmus,LLMI）消融（LLMI组）,对比两组消融线的双向阻滞率和临床疗效。结果 LAAW组前壁线双向阻滞22例（78.6%）;手术3个月后,房颤复发7例（25.0%）;LLMI组二尖瓣峡部线双向阻滞15例（53.6%）;手术3个月后,房颤复发15例（53.6%）。两组比较：LAAW组前壁线双向阻滞率高于LLMI组的二尖瓣峡部线;3个月后房颤复发率LAAW组低于LLMI组,差异均具有统计学意义。结论对持续性房颤,在左房前壁低电压区进行前壁线消融,可能有助于提高消融线的双向阻滞率,提高持续性房颤的导管消融成功率。Objective To compare the efficiency and safety of left atrial anterior wal ablation through low-voltage area versus left lateral mitral isthmus ablation in patients with persistent atrial fibrilation.Methods Sixty patients with persistent atrail fibrilation from August 1,2012 to September 30,2013 were enroled and divided into two groups according to the evolution of ablation strategies： LAAW（left atrial anterior wal ablation through low-voltage） and LLMI（left lateral mitral isthmus ablation）.ResultsThe achievement of bidirectional block of LAAW was higher than LLMI ablation（78.6%vs. 53.6%）. During folow-up of 18 months,the recurrence rate of atrial fibrilation after LAAW ablation was significantly lower than that of LLMI ablation（25.0%vs. 53.6%）.Conclusion Linear ablation along left atrial anterior wal through low-voltage is safe and may results in a better clinical outcome with a higher rate of bidirectional conduction block to LLMI ablation.

关 键 词：心房颤动 电压图 左房前壁线 二尖瓣峡部线 导管消融 

分 类 号：R541[医药卫生—心血管疾病]