心房颤动病人再次射频消融手术安全性和有效性的临床研究  

The Safety and Efficacy of Repeat Radiofrequency Ablation in Patients with Atrial Fibrillation

作　　者：袁伟[1] 张林忠[2] 张玮[1] 李小荣 阮中宝[1] 陈铭[1] 曹克将[4] YUAN Wei;ZHANG Linzhong;ZHANG Wei;LI Xiaorong;RUAN Zhongbao;CHEN Ming;CAO Kejiang(Taizhou People's Hospital,Taizhou 225300,Jiangsu,China)

机构地区：[1]泰州市人民医院,江苏泰州225300 [2]济南市中心医院 [3]同济大学附属东方医院/上海市东方医院,上海200120 [4]南京医科大学第一附属医院/江苏省人民医院

出　　处：《中西医结合心脑血管病杂志》2020年第21期3548-3551,共4页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

基　　金：国家自然科学基金(No.81400253);浦东新区临床高峰学科(No.PWYgf2018-02)。

摘　　要：目的探讨射频消融术后心房颤动复发病人的临床特点,同时通过与首次手术病人比较评价其再次行导管射频消融术的安全性。方法选取2009年10月—2011年6月在江苏省人民医院心脏科行射频消融术的心房颤动病人435例,其中首次射频消融术345例(首次手术组),二次射频消融术90例(再次手术组)。比较两组心房颤动类型、心脏超声指标、生化指标以及手术并发症等,并在术后1个月、3个月、6个月、12个月进行临床随访。结果两组病人心房颤动类型、心脏超声指标、生化指标等临床资料比较差异均无统计学意义(P>0.05);再次手术组并发症发生率低于首次手术组,但差异无统计学意义(P>0.05);两组手术随访1年,再次手术组复发率低于首次手术组(20.00%与33.33%,P=0.014);再次手术组阵发性心房颤动复发率明显低于首次手术组(16.88%与29.00%,P=0.033)。结论心房颤动复发病人行再次射频消融手术与首次手术相比同样安全,复发病人尤其是阵发性心房颤动术后复发病人可以尝试再次射频消融手术治疗。Objective To investigate the clinical characteristics of patients with recurrent atrial fibrillation and to evaluate the safety of re-catheter radiofrequency ablation compared with that in patients undergoing first operation.Methods Four hundred and thirty-five patients with atrial fibrillation undergoing catheter radiofrequency ablation were selected,including 345 patients with first ablation(first ablation group)and 90 patients with repeat ablation(repeat ablation group).The types of atrial fibrillation,echocardiographic indicators,biochemical indicators,and surgical complications were compared between two groups.At 1 month,3 months,6 months,and 12 months after operation,the patients were followed up in the outpatient department for dynamic electrocardiogram examination.Results There was no significant difference in atrial fibrillation type,cardiac ultrasound index,biochemical index and other clinical data between two groups(P>0.05).The complication rate of repeat ablation group was lower than that of first ablation group,but there was no significant difference(P>0.05).The recurrence rate of repeat ablation group was lower than that of first ablation group(20.00%vs 33.33%,P=0.014).The recurrence rate of paroxysmal atrial fibrillation in repeat ablation group was lower than that in first ablation group(16.88%vs 29.00%,P=0.033).Conclusion The repeat ablation for atrial fibrillation is as safe as the first ablation in patients with atrial fibrillation.It is recommended that patients with recurrent atrial fibrillation,especially those with recurrent paroxysmal atrial fibrillation,should try repeat ablation.

关 键 词：心房颤动 射频消融术 临床特点 并发症 安全性 

分 类 号：R541.7[医药卫生—心血管疾病] R256.2[医药卫生—内科学]