成人房间隔缺损经导管封堵术后心房颤动的长期随访  

Long-term Incidence of Atrail Fibrillation after Transcatheter Closure in Adult Patients with Atrial Septal Defects

作　　者：李小庆[1] 成力[2] 成小凤[1] 覃军[1] 于世勇[1] 

机构地区：[1]第三军医大学新桥医院心血管内科,重庆400037 [2]广东医学院附属医院心血管内科,湛江524023

出　　处：《宁夏医科大学学报》2017年第3期264-267,共4页Journal of Ningxia Medical University

摘　　要：目的观察成人房间隔缺损(atrial septal defects,ASD)封堵术后患者在长期随访中心房颤动(atrial fibrillation,AF)的发生率。方法观察213例接受经导管ASD封堵的成人患者,随访5年,以发生长期持续性心房颤动(房颤)为观察终点。结果术前长期持续性房颤的患者术后均维持长期持续性房颤;术前持续性房颤的患者术后长期持续性房颤3年发生率为14.30%,5年发生率为35.70%;术后持续性房颤3年发生率为14.30%,5年发生率为48.60%;术前阵发性房颤的患者术后阵发性房颤3年发生率为19.20%,5年发生率为66.30%;术前无房颤的患者术后阵发性房颤3年发生率为0.52%,5年发生率为0.52%。结论无房颤或有阵发性房颤病史的成人患者经导管ASD封堵术避免了向房颤进展,部分持续性房颤病例同时行ASD封堵和电复律可恢复窦性心律并长期维持。Objective To investigate the long-term adult patients with atrial septal defects. Methods incidence of atrial fibrillation after transcatheter closure in 213 adult patients who had accepted transcatheter ASD closure in our hospital were recruited. Patients were followed for 5 years or longstanding persistent AF occured. Results Patients with longstanding persistent AF before closure stayed in the status after closure. 3 year incidence of longstanding persistent AF in patients with persistent AF before closure was 14.3% and 5 year incidence was 35.7%. 3 and 5 year incidence of persistent AF was 14.3% and 48.6% ,respectively. 3 year incidence of paroxysmal AF in patients with paroxysmal AF before closure was 19.2% and 5 year incidence was 66.3%. 3 year and 5 year incidence of paroxysmal AF in patient without AF before closure were both 0.52%. Conclusion Transcatheter ASD closure performed in adults with no history of AF or with a history of paroxysmal AF before closure seems to protect from development of AF in the long-term. In selected patients with persistent AF at closure, device ASD closure together with arrhythmia cardioversion might be able to restore and maintain sinus rhythm in the long-term.

关 键 词：房间隔缺损 心房颤动 经导管封堵 

分 类 号：R541.75[医药卫生—心血管疾病]