环肺静脉电隔离术对心肌病阵发性心房颤动患者心脏逆重构的影响  

Effect of annular pulmonary vein electrical isolation method on reversal and remodeling cardiomyopathic patients with paroxysmal atrial fibrillation

作　　者：余阳[1] 杨洪涛[1] 卢清玉[1] YU Yang;YANG Hong-tao;LU Qing-yu(Department of Cardiovascular Internal Medicine, Beijing Haidian Hospital/Haidian Support, Peking University Third Hospital, Beijing 100080, China)

机构地区：[1]北京市海淀医院/北京大学第三医院海淀院区心血管内科,北京100080

出　　处：《临床和实验医学杂志》2018年第5期520-523,共4页Journal of Clinical and Experimental Medicine

摘　　要：目的观察并评价环肺静脉电隔离术对心肌病阵发性心房颤动(房颤)患者心脏逆重构的影响。方法采用前瞻性研究方法将65例心肌病阵发性房颤患者随机分为两组,对照组(n=32)给予药物控制治疗,观察组(n=33)给予环肺静脉电隔离术治疗。观察两组患者治疗前、治疗后6个月的左房内径(LAD)、左室舒张末径(LVEDD)、左室射血分数(LVEF)、左房容积(LAV)、左心室后壁厚度(LVPW)和室间隔厚度(IVS),同时观察两组的临床疗效和并发症发生情况。结果观察组治疗6个月后的LAD、LVEDD、LVEF、LVPW、IVS、LAV均较治疗前改善(P<0.05);观察组的治疗总有效率(90.91%)明显高于对照组(37.50%),差异有显著性(P<0.05)。观察组严重并发症发生率(0)明显低于对照组(25.00%),差异有显著性(P<0.05)。结论环肺静脉电隔离术对心肌病阵发性心房颤动患者心脏逆重构有显著的积极影响,且安全性高于常规药物治疗。Objective To explore the effect of application of annular pulmonary vein electrical isolation method for reversal and remodeling cardiomyopathy in patients with myocardial disease complicated with paroxysmal atrial fibrillation.Methods A total of65patients with cardiomyopathy and paroxysmal atrial fibrillation were randomly divided into two groups.Patients in control group(n=32)received drug control treatment,and patients in observation group(n=33)received circumferential pulmonary vein isolation treatment.The left atrial diameter in6months after treatment in patients of these2groups before and after treatment(LAD),left ventricular end diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF),left atrial volume(LAV),left ventricular posterior wall thickness(LVPW)and thickness of interventricular septum(IVS)were observed in patients of these2groups.At the same time,clinical curative effect and complications were observed in patients of these2groups Results After6months of treatment,LAD,LVEDD,LVEF,LVPW,IVS and LAV in patients of observation group were improved(P<0.05).The total effective rate of patients in observation group(90.91%)was significantly higher than that(37.50%)of patients in control group,and the difference was significant(P<0.05).The incidence of severe complications in patients of observation group(0)was significantly lower than that(25.00%)of patients in control group,and the difference was significant(P<0.05).Conclusion The application of radiofrequency ablation for reversal of remodeling cardiomyopathy patients with paroxysmal atrial fibrillation has significant efficacy,and its safety is higher than that of conventional treatment with drug.

关 键 词：心肌病 阵发性心房颤动 环肺静脉电隔离术 心脏逆重构 

分 类 号：R541.75[医药卫生—心血管疾病]