环肺静脉隔离联合左心房顶部线性消融对心房颤动患者消融成功率、心功能及并发症的影响  

Effects of Circumferential Pulmonary Vein Isolation Combined with Linear Ablation of Left Atrium Roof on Ablation Success Rate,Cardiac Function and Complications in Patients with Atrial Fibrillation

作　　者：王红 马晓峰 许萍 高琴 WANG Hong;MA Xiao-feng;XU Ping;GAO Qin(Department of Cardiology,Qinghai Provincial Hospital of Cardiovascular and Cerebrovascular Diseases,Xining 810012,China)

机构地区：[1]青海省心脑血管病专科医院心内科,西宁810012

出　　处：《解放军医药杂志》2022年第10期4-7,共4页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：青海省卫生和计划生育委员会科研课题(2018-wjzdx-34)。

摘　　要：目的研究环肺静脉隔离联合左心房顶部线性消融对心房颤动患者消融成功率、心功能及并发症的影响。方法选取2018年9月—2021年5月收治的103例阵发性心房颤动为研究对象,根据治疗方式不同分为对照组49例和观察组54例。对照组予以环肺静脉隔离治疗,观察组予以环肺静脉隔离联合左心房顶部线性消融治疗。比较2组手术相关指标、消融成功率、左心房最大面积(LAA)、左心房最大容积(LAV)、二尖瓣血流频谱A峰峰值流速(VA)、左心房射血力(LAF)及并发症发生率。结果观察组手术时间、消融时间均明显长于对照组(P<0.05);但2组X线下曝光时间比较差异无统计学意义(P>0.05)。观察组消融成功率明显高于对照组(P<0.05)。治疗后,2组LAA、LAV水平均较治疗前下降,VA、LAF水平较治疗前上升;且观察组LAA、LAV水平均低于对照组,VA、LAF水平均高于对照组(P<0.05)。观察组并发症总发生率明显低于对照组(P<0.05)。结论环肺静脉隔离联合左心房顶部线性消融治疗心房颤动患者消融成功率高,可改善心功能,且能降低并发症发生率。Objective To study the effects of circumferential pulmonary vein isolation(CPVI)combined with linear ablation of left atrium roof on the success rate of ablation,cardiac function and complications in patients with atrial fibrillation.Methods A total of 103 patients with paroxysmal atrial fibrillation admitted from September 2018 to May 2021 were selected as the research subjects.According to different treatment methods,they were divided into the control group(n=49)and the observation group(n=54).The control group was treated with CPVI,while the observation group was treated with CPVI combined with linear ablation of left atrium roof.Surgery-related parameters,ablation success rate,the maximum left atrial area(LAA),the maximum left atrium volume(LAV),peak velocity of mitral valve inflow(VA)based on mitral valve blood flow spectrum A peak,left atrial ejection force(LAF)and incidence of complications were compared between the two groups.Results The duration of operation and ablation time of the observation group were significantly longer than those of the control group(P<0.05).However,there was no significant difference in X-ray exposure time between the two groups(P>0.05).The ablation success rate of the observation group was significantly higher than that of the control group(P<0.05).After treatment,the levels of LAA and LAV in the two groups were decreased compared with those before treatment,while the levels of VA and LAF were increased.The levels of LAA and LAV in the observation group were lower than those in the control group,while the levels of VA and LAF in the observation group were higher than those in the control group(P<0.05).The total incidence of complications in the observation group was significantly lower than that in the control group(P<0.05).Conclusion CPVI combined with linear ablation of the left atrial roof in the treatment of patients with atrial fibrillation has a high ablation success rate,which can improve cardiac function and reduce the incidence of complications.

关 键 词：心房颤动 环肺静脉隔离 左心房顶部线性消融 消融成功率 心房功能 左 并发症 

分 类 号：R541.75[医药卫生—心血管疾病]