消融指数在房颤导管消融中的应用价值分析  

Application value of ablation index in catheter ablation of atrial fibrillation

作　　者：杨明[1] 郝应禄[1] 梁梅[1] 王鹏宇 YANG Ming;HAO Ying-lu;LIANG Mei(Department of Cardiology,Yuxi People's Hospital,Yuxi 653100,China)

机构地区：[1]玉溪市人民医院心内科,653100

出　　处：《中国现代药物应用》2022年第18期1-5,共5页Chinese Journal of Modern Drug Application

摘　　要：目的 对比应用消融指数(AI)指导和常规方法进行心房颤动(房颤)导管消融的效果,分析AI在房颤导管消融中的应用价值。方法 100例非瓣膜性阵发性房颤患者,随机分为对照组和研究组,每组50例。两组均在Carto3三维标测系统下,采用逐点消融的方法进行双侧肺静脉隔离。研究组根据AI目标值指导进行导管消融,对照组采取常规方法进行导管消融。比较两组患者手术情况(手术时间、消融时间、放射剂量、肺静脉完全隔离、上腔静脉隔离、三尖瓣峡部线性消融)、术中和术后并发症(急性心包填塞、脑梗死、食管心房瘘、肺静脉狭窄、膈神经损伤)发生率、窦性心律维持率。结果 两组患者术中均成功实现肺静脉完全隔离。两组上腔静脉隔离、三尖瓣峡部线性消融发生率比较差异无统计学意义(P>0.05)。研究组手术时间(88.3±27.6)min、放射剂量(24.7±12.3)mGy与对照组的(92.7±23.1)min、(23.5±14.8)m Gy比较差异无统计学意义(P>0.05);研究组消融时间(52.8±12.6)min短于对照组的(58.9±16.4)min,差异具有统计学意义(P<0.05)。两组患者急性心包填塞发生率比较差异无统计学意义(P>0.05)。经过12个月的随访,对照组有44例(88.0%)维持窦性心律,研究组有43例(86.0%)维持窦性心律。两组患者窦性心律维持率比较差异无统计学意义(χ^(2)=0.09, P=0.77>0.05)。结论 应用AI指导房颤导管消融不一定能提高术后窦性心律维持率。Objective To compare the effect of ablation index(AI)and conventional method in catheter ablation of atrial fibrillation,and analyze the application value of AI in catheter ablation of atrial fibrillation.Methods A total of 100 patients with non-valvular paroxysmal atrial fibrillation were randomly divided into control group and research group,with 50 cases in each group.Both groups underwent bilateral pulmonary vein isolation by point-by-point ablation under the Carto3 three-dimensional mapping system.The research group performed catheter ablation guided by the AI target value,while the control group performed catheter ablation by conventional methods.Both groups were compared in terms of surgery(operation time,ablation time,radiation dose,complete isolation of pulmonary veins,superior vena cava isolation,linear ablation of tricuspid isthmus),incidence of intraoperative and postoperative complications(acute cardiac tamponade,cerebral infarction,esophageal atrium fistula,pulmonary vein stenosis,phrenic nerve injury),maintenance rate of sinus rhythm.Results Complete isolation of pulmonary veins of the pulmonary veins was successfully achieved in both groups during surgery.There was no statistically significant difference in the incidence of superior vena cava isolation,linear ablation of tricuspid isthmus between the two groups(P>0.05).The operation time and radiation dose of the research group were(88.3±27.6)min and(24.7±12.3)mGy,which were not significantly different from(92.7±23.1)min and(23.5±14.8)mGy of the control group(P>0.05).The ablation time(52.8±12.6)min of the research group was shorter than(58.9±16.4)min of the control group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in the incidence of acute cardiac tamponade between the two groups(P>0.05).After 12 months of follow-up,44 patients(88.0%)maintained sinus rhythm in the control group,and 43 patients(86.0%)in the research group maintained sinus rhythm.There was no statistically signific

关 键 词：心房颤动 导管消融 消融指数 窦性心律维持率 

分 类 号：R541.75[医药卫生—心血管疾病]