心房颤动射频消融术后不同结果对左心耳结构重构的影响  

Effects of Different Outcomes on Structural Remodeling of the Left Auricle after Ra⁃diofrequency Ablation of Atrial Fibrillation

作　　者：杜薇 罗彩东[1] 戴闽[1] 黎东[1] 赖柱宏 王虎 牟英[1] DU Wei;LUO Caidong;DAI Min;LI Dong;LAI Zhuhong;WANG Hu;MOU Ying(Department of Cardiovascular Medicine,Mianyang Central Hospital,Mianyang,Sichuan Province,621000 China)

机构地区：[1]绵阳市中心医院心血管内科,四川绵阳621000

出　　处：《世界复合医学》2022年第10期1-5,10,共6页World Journal of Complex Medicine

基　　金：绵阳市中心医院2019年度孵化课题立项(2019FH10)。

摘　　要：目的探究心房颤动射频消融术后有无房颤复发对左心耳结构重构的影响。方法选择2018年1月—2019年6月于绵阳市中心医院心血管内科首次成功接受射频消融治疗的非瓣膜性房颤患者42例,术后随访24个月观察是否有房颤复发,利用患者手术前后冠状动脉增强CT影像评估其左心耳容积及变化。结果共入选房颤患者42例,随访期间16例(38.1%)患者房颤复发。射频消融术后24个月对患者左心耳容积和左房容积进行复查,房颤复发的患者左心耳容积(12.8±2.8)mL、左房容积(150.3±29.6)mL较术前[(10.4±3.5)、(133.7±32.4)mL]显著增大,差异有统计学意义(t=-5.080、-6.375,P<0.05)。而无房颤复发的患者左心耳容积(9.2±3.5)mL与术前(8.7±3.5)mL相比,差异无统计学意义(t=-1.432,P=0.165),其左房容积(100.0±28.3)mL较术前(102.6±29.9)mL有所缩小,但差异无统计学意义(t=0.937,P=0.358)。结论射频消融术成功治疗房颤后(术后24个月无房颤复发)可在一定程度上抑制并逆转房颤进程中发生的左心房和左心耳结构重构。Objective To investigate the influence of the presence or absence of atrial fibrillation recurrence on the structural remodeling of the left heart ear after radiofrequency ablation of atrial fibrillation.Methods Forty-two patients with non-valvular atrial fibrillation who were subsuccessfully treated with radiofrequency ablation at the Cardiovascular Medicine Department of Mianyang Central Hospital from January 2018 to June 2019 were selected.Postoperative follow-up was performed for 24 months to observe whether there was recurrence of atrial fibrillation.The patients′left ear volumes and changes were evaluated using coronary artery-enhanced CT images before and after the procedure.Results A total of 42 patients with atrial fibrillation were selected,and 16 patients(38.1%)relapsed during the follow-up period.The left atrial appendage volume and left atrial volume of patients with recurrent atrial fibrillation were rechecked 24 months after radiofrequency ablation.The left atrial appendage volume of patients with recurrent atrial fibrillation was(12.8±2.8)mL and left atrial volume was(150.3±29.6)mL,significantly higher than that of patients before radiofrequency ablation(10.4±3.5)mL and(133.7±32.4)mL,and the difference was statistically significant(t=-5.080,-6.375,P<0.05).There was no statistically significant difference between the volume of left atrial appendage(9.2±3.5)mL in patients without recurrence of atrial fibrillation and that before operation(8.7±3.5)mL(t=-1.432,P=0.165).In patients without recurrence of atrial fibrillation,the left atrial volume(100.0±28.3)mL was smaller than that before operation(102.6±29.9)mL,but the difference was not statistically significant(t=0.937,P=0.358).Conclusion After successful treatment of atrial fibrillation(no recurrence of atrial fibrillation 24 months after operation),radiofrequency ablation can inhibit and reverse the structural remodeling of left atrium and left atrial appendage during atrial fibrillation to a certain extent.

关 键 词：心房颤动 左心耳 结构重构 射频消融术 

分 类 号：R541.75[医药卫生—心血管疾病]