高功率短时程消融在老年心房颤动患者中的可行性及应用优势分析  

Feasibility and advantages of high power short duration ablation in elderly patients with atrial fibrillation

作　　者：李健[1] 李世兴 张闯[1] 时向民[1] Li Jian;Li Shixing;Zhang Chuang;Shi Xiangmin(Department of Cardiovscular Dieseases,the Sixth Medical Center of Chinese PLA General Hospital,Beijing 100048,China)

机构地区：[1]解放军总医院第六医学中心心血管病医学部,北京100048

出　　处：《中华老年心脑血管病杂志》2022年第11期1132-1134,共3页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：军队保健专项科研课题(18BJZ40);军队医学科研项目(17QNP035)。

摘　　要：目的探讨在老年心房颤动(房颤)患者中应用高功率短时程消融的可行性及优势。方法选取2021年9月至2022年4月解放军总医院第六医学中心心血管病医学部接受高功率短时程导管射频消融的老年房颤患者40例(高功率组),同期接受常规功率消融的老年房颤患者40例(传统消融组),比较2组消融指标、单圈隔离率、术中耐受程度及围术期并发症发生率。结果高功率组消融时间、消融点、盐水灌注量较传统消融组明显减少[(29.0±6.5)min vs(68.6±12.0)min,P<0.01;(70.5±8.0)个vs(94.1±18.3)个,P<0.01;(294.7±34.4)ml vs(545.9±106.4)ml,P<0.01]。高功率组术中芬太尼使用量和因疼痛终止消融次数明显减少[(59.4±14.6)μg vs(79.4±16.9)μg,P<0.01;(0.5±0.2)次vs(1.5±1.4)次,P<0.01]。结论在老年房颤消融术中,高功率短时程消融明显缩短手术时间,患者耐受程度好,手术效果与常规功率消融相仿,且不增加围术期并发症发生率,有较为明显的优势。Objective To explore the feasibility and advantages of high power short duration(HPSD)ablation in the elderly patients with atrial fibrillation(AF).Methods A total of 40 elderly AF patients undergoing HPSD ablation in our department from September 2021 to April 2022 were enrolled as the HDSP group,and another 40 elderly AF patients receiving conventional power ablation therapy(CAT)in the same period were subjected as the CAT group.The ablation parameters,first-pass pulmonary vein isolation rate,intra-operative tolerance and perioperative incidence of complications were compared between the 2 groups.Results The HDSP group had shorter ablation time(29.0±6.5 min vs 68.6±12.0 min,P<0.01),fewer ablation points(70.5±8.0 vs 94.1±18.3,P<0.01),and less volume of saline intake(294.7±34.4 ml vs 545.9±106.4 ml,P<0.01)when compared with the CAT group.The total dose of fentanyl during operation(59.4±14.6μg vs 79.4±16.9μg,P<0.01)and frequency of pain-triggered termination of ablation(0.5±0.2 vs 1.5±1.4,P<0.01)were remarkable reduced in the HPSD group than the CAT group.Conclusion HDSP ablation significantly shortens the operation time,and obtains good patient tolerance for the elderly AF patients.Its surgical effect iveness is similar to that of CAT,and it does not increase the incidence of perioperative complications.

关 键 词：导管消融术 心房颤动 手术中并发症 自身耐受性 

分 类 号：R541.75[医药卫生—心血管疾病]