症状性频发房性早搏的射频消融治疗  

Efficacy analysis of radiofrequency ablation for symptomatic frequent premature atrial contractions

作　　者：胡菁[1] 赖珩莉[1] 邹晋 王晶 杨柳[1] 涂伟玲[1] 方雁[1] HU Jing;LAI Heng-li;ZOU Jin;WANG Jing;YANG Liu;TU Wei-ling;FANG Yan(Jiangxi Provincial People's Hospital,The First Affiliated Hospital of Nanchang Medical College,Nanchang 360000,Jiangxi,China)

机构地区：[1]江西省人民医院(南昌医学院第一附属医院)心血管内科,江西南昌360000

出　　处：《中国心脏起搏与心电生理杂志》2022年第6期504-508,共5页Chinese Journal of Cardiac Pacing and Electrophysiology

基　　金：江西省卫生健康委科技计划项目资助(SKJP220202088)。

摘　　要：目的 探讨射频消融治疗症状性频发房性早搏(简称房早)的疗效。方法 收集2019年1月至2021年5月心电图证实频发房早,行射频消融治疗的患者35例,药物治疗的患者34例,对两组组间及每组治疗前后资料进行对比分析,了解导管消融治疗房早的疗效。结果 射频组35例患者房早起源按解剖部位分析,左房来源17例,其中肺静脉来源11例(31%);右房来源18例,其中高位右房、His束旁来源各5例(11%)。射频组及药物组治疗前后24 h房早[24 811(17 007,43 467)vs 150(47,492),11 461(10 182,12 945)vs 5 745(2 995,11 682)]、房早负荷[22.32(17.51,38.56)vs 0.15(0.05,0.57),12.06(10.84,13.29)vs 6.74(3.47,12.07)]差异均具有显著性(P均<0.001),而24 h房性心动过速仅射频组有差异[638(96,2 664)vs 0(0,3),P<0.001]。射频组与药物组两组间治疗后24 h房早、房早负荷及24 h房性心动过速有明显差异(P均<0.001)。射频组发生1例房室传导阻滞并植入永久起搏器,随访6~35个月,药物组发生6例心房颤动、3例脑卒中、4例心力衰竭;射频组无相应病例发生。结论 射频消融治疗症状性频发房早是安全、有效的,疗效明显优于药物治疗。Objective To investigate the efficacy of radiofrequency ablation in the treatment of symptomatic frequent premature atrial contractions(PAC). Methods Frequent PAC confirmed by electrocardiogram 35 patients with radiofrequency ablation(RF group) and 34 patients with drug therapy(Drug group) were collected from January 2019 to May 2021. The results of the two groups were compared and analyzed horizontally(between groups) and longitudinally(before and after treatment),to understand the efficacy of catheter ablation in the treatment of PAC. Results In the RF group, PAC origin was analyzed by anatomical site, including 17 cases from left atrial, 11 cases from pulmonary vein(31%). There were 18 cases from right atrial, including 5 cases from high right atrial and 5 cases from para-His bundle(11%). There were statistically significant differences(P<0.001) in 24 h PAC [24 811(17 007,43 467)vs 150(47,492),11 461(10 182,12 945)vs 5 745(2 995,11 682)]and PAC load[22.32(17.51,38.56)vs 0.15(0.05,0.57),12.06(10.84,13.29)vs 6.74(3.47,12.07)]between the RF group and the drug group before and after treatment. There were significant differences in 24 h PAC, 24 h PAC load and 24 h atrial tachycardia between the RF group and the drug group(P< 0.001).In the during 6-35 months follow-up, 1 case of atrioventricular block and permanent pacemaker implantation occurred in the RF group, and 6 cases of atrial fibrillation, 3 cases of stroke, and 4 cases of heart failure occurred in the drug group. Conclusions Radiofrequency ablation is safe and effective in the treatment of symptomatic frequent PAC, and better than drug therapy.[Chinese Journal of Cardiac Pacing and Electrophysiology,2022,36(6):504-508]

关 键 词：心血管病学 频发房性早搏 射频消融 疗效 

分 类 号：R541.7[医药卫生—心血管疾病] R454.1[医药卫生—内科学]