基层医院三维指导下射频消融治疗心律失常95例临床分析  

Three-Dimensional Image-Guided Radiofrequency Ablation for Arrhythmia in Basic-Level Hospitals: a Clinical Analysis of 95 Cases

作　　者：钱剑峰[1] 刘庆军[1] QIAN Jian-feng;LIU Qing-jun(Department of Cardiology,Kunshan Hospital of Traditional Chinese Medicine,Kunshan 215300,China)

机构地区：[1]昆山市中医医院心内科,江苏昆山215300

出　　处：《实用临床医学（江西）》2019年第1期9-11,14,共4页Practical Clinical Medicine

摘　　要：目的探讨三维指导下消融治疗心律失常在基层医院开展的有效性及安全性。方法对2015—2017年在昆山市中医医院行三维指导下射频消融治疗的95例心律失常患者的临床资料进行回顾分析,其中室上性心动过速40例,阵发性房颤21例,流出道室早30例,左室特发性室速4例。结果 40例室上性心动过速患者消融一次成功率为92.5%,复发率为5.1%;21例阵发性房颤患者消融一次成功率为76.19%,复发率为23.81%;30例流出道室性早搏患者消融一次成功率为90.0%,复发率为6.4%;4例左室特发性室速患者消融一次成功率为100.0%。1例室上性心动过速患者行慢径改良时出现短暂性Ⅲ度房室传导阻滞,2例房颤患者左上肺静脉消融时出现严重迷走反射,1例室性早搏患者术后出现股动脉穿刺处血肿。结论三维指导下射频消融是根治心律失常的一项安全、有效的方法,可以在基层医院开展。Objective To explore the clinical efficacy and safety of three-dimensional image-guided radiofrequency ablation in treatment of arrhythmia in basic-level hospitals. Methods A retrospective analysis was performed on 95 patients with arrhythmia who underwent three-dimensional image-guided radiofrequency ablation in Kunshan Hospital of Traditional Chinese Medicine from 2015 to 2017.Among them,40 patients had supraventricular tachycardia,21 patients had paroxysmal atrial fibrillation,30 patients had ventricular premature beats from ventricular outflow tract,and 4 patients had left idiopathic ventricular tachycardia. Results The success rate of the first attempt at radiofrequency ablation and the recurrence rate were respectively 92.5% and 5.1% among the 40 cases of supraventricular tachycardia,76.19% and 23.81% among the 21 cases of paroxysmal atrial fibrillation,and 90.0% and 6.4% among the 30 cases of ventricular premature beats from ventricular outflow tract.The success rate was 100.0% among the 4 cases of left idiopathic ventricular tachycardia.Transient Ⅲ-degree atrioventricular block occurred in 1 patient with supraventricular tachycardia during slow path improvement.Severe vagal reflex was found in 2 patients with atrial fibrillation during left superior pulmonary vein ablation.One patient with ventricular premature beats had hematoma at the puncture site of femoral artery after operation. Conclusion Three-dimensional image-guided radiofrequency ablation is a safe and effective treatment for arrhythmia.It can be carried out in basic-level hospitals.

关 键 词：射频消融术 三维 心律失常 基层医院 

分 类 号：R541.7[医药卫生—心血管疾病]