碎裂电位消融联合环肺静脉电隔离消融对持久性房颤患者心房功能的影响  

Effect of complex fractionated atrial electrograms combined with circumferential pulmonary vein isolation on atrial function in patients with persistent atrial fibrillation

作　　者：白宝宝 王芳芳 刘雄涛 曾迪 廉诚 李雪 BAI Baobao;WANG Fangfang;LIU Xiongtao;ZENG Di;LIAN Cheng;LI Xue(Department of Cardiology,the Second Affiliated Hospital of PLA Air Force Military Medical University,Shaanxi Province,Xi′an 710038,China)

机构地区：[1]解放军空军军医大学第二附属医院心内科,陕西西安710038

出　　处：《中国医药导报》2018年第35期54-57,183,共5页China Medical Herald

基　　金：陕西省重点研发计划项目(S2017-ZDYF-YBXM-SF-0358)

摘　　要：目的探讨碎裂电位消融(CFAE)联合环肺静脉电隔离消融(CPVI)对持久性房颤患者心房功能的影响。方法选择2014年3月～2017年3月在解放军空军军医大学第二附属医院接受治疗的持久性房颤患者124例,随机数字表法分为两组,CPVI组和CPVA+CFAE组,每组62例。所有入院患者均常规检查,记录两组手术时间和X线透视时间,分析比较两组患者手术结果及房颤终止后的消融情况。术后随访12个月,采用Kaplan-meier生存曲线分析两组的窦性心律维持情况。结果 CPVI+CFAE组手术时间较CPVI组长,差异有统计学意义(P <0.05)。两组术后恢复及并发症发生情况比较,差异均有统计学意义(P <0.05)。Kaplan-meier生存曲线分析结果显示,CPVI+CFAE组较CPVI组窦性心律维持时间显著延长(P <0.05)。结论 CPVI+CFAE联合消融治疗持久性房颤,消融术中终止或转变成功率高,可最大程度将持久性房颤消融终止或转变为房性心动过速,且维持率高。Objective To investigate the effect of complex fractionated atrial electrograms(CFAE)combined with circumferential pulmonary vein isolation(CPVI)on atrial function in patients with persistent atrial fibrillation.Methods A total of124patients with persistent atrial fibrillation having received treatment in the Second Affiliated Hospital of PLA Air Force Military Medical University from March2014to March2017were selected and they were divided into CPVI group and CPVA+CFAE group by random number table method,with62cases in each group.All the patients admitted to the hospital were routinely examined,and the operation time and X-ray fluoroscopy time of the two groups were recorded,and the operation results,ablation after the end of atrial fibrillation of the two groups were analyzed and compared.After12months′follow-up,Kaplan-meier survival curve was used to analyze the maintenance of sinus rhythm in the two groups.Results The operation time of the CPVI+CFAE group was longer than that of the CPVI group,and the difference was statistically significant(P<0.05).The postoperative status and complications of the two groups were compared,and the differences were statistically significant(P<0.05).Kaplan-meier survival curve analysis showed that the maintenance rate of sinus rhythm in the CPVI+CFAE group was significantly higher than that in the CPVI group(P<0.05).Conclusion CPVI+CFAE combined with ablation in the treatment of persistent atrial fibrillation has a high success rate in the termination or transformation during ablation,which can terminate or transform persistent atrial fibrillation into atrial tachycardia to a largest degree,and the maintenance rate is high.

关 键 词：碎裂电位消融 环肺静脉电隔离消融 持久性心房颤动 房性快速性心律失常 

分 类 号：R541[医药卫生—心血管疾病]