Marshall静脉无水乙醇消融联合导管射频消融术治疗阵发性心房颤动的应用研究  

Application study of anhydrous ethanol ablation of vein of Marshall combined with radiofrequency catheter ablation in treatment of paroxysmal atrial fibrillation

作　　者：刘相飞[1] 马晓羽 公言伟 Liu Xiangfei;Ma Xiaoyu;Gong Yanwei(Department of Cardiology,Central Hospital of Shengli Oil Field,Dongying 257034,China)

机构地区：[1]胜利油田中心医院心内科,山东东营257034

出　　处：《临床内科杂志》2023年第2期86-89,共4页Journal of Clinical Internal Medicine

基　　金：山东省医药卫生科技发展计划项目(202103010895)。

摘　　要：目的比较Marshall静脉(VOM)无水乙醇消融联合导管射频消融术与单纯导管射频消融术治疗阵发性心房颤动(PAF)的有效性和安全性。方法依据是否行VOM无水乙醇消融将199例PAF患者分为对照组(单纯行导管射频消融术)148例和观察组(VOM无水乙醇消融联合导管射频消融术)51例。比较两组患者手术相关资料、术后6、12、18个月心房颤动(AF)复发情况及手术并发症、脑卒中、死亡发生情况。结果观察组患者总手术时间及总透视时间均长于对照组(P<0.05),而两组即时环肺静脉电隔离(CPVI)成功患者比例比较差异无统计学意义(P>0.05)。术后6个月两组AF复发患者比例比较差异无统计学意义(P>0.05),而术后12个月、18个月观察组AF复发患者比例均低于对照组(P<0.05)。随访期间,两组发生严重血管并发症患者比例比较差异无统计学意义(P>0.05),两组患者均未出现心脏压塞、心房食管瘘、脑卒中、死亡等。结论VOM无水乙醇消融联合导管射频消融术治疗PAF安全、可靠,其远期疗效优于单纯行导管射频消融术。Objective To compare effectiveness and safety in treating paroxysmal atrial fibrillation(PAF)between anhydrous ethanol ablation of vein of Marshall(VOM)combined with radiofrequency catheter ablation and radiofrequency catheter ablation alone.Methods According to whether to use anhydrous ethanol ablation of VOM or not,199 patients with PAF were divided into control group(148 cases)who underwent radiofrequency catheter ablation alone and observation group(51 cases)who underwent anhydrous ethanol ablation of VOM combined with radiofrequency catheter ablation.Operation related data,recurrence condition of atrial fibrillation(AF)6,12 and 18 months after operation and occurrence of surgical complications,stroke and death were compared between the two groups.Results Total operation time and total fluoroscopy time of patients in observation group were longer than those in control group(P<0.05),while there was no significant difference of proportion of patients with immediate circumferential pulmonary vein isolation(CPVI)between the two groups(P>0.05).There was no significant difference of proportion of patients with recurrence of AF 6 months after operation between the two groups(P>0.05),while proportions of patients with recurrence of AF 12 and 18 months after operation in observation group were lower than those in control group(P<0.05).During the follow-up period,there was no significant difference in proportion of patients with serious vascular complications between the two groups(P>0.05),and there were no cardiac tamponade,atrial esophageal fistula,stroke and death in the two groups.ConclusionAnhydrous ethanol ablation of VOM combined with radiofrequency catheter ablation in treating PAF is safe and reliable,and the long-term effect is better than radiofrequency catheter ablation alone.

关 键 词：Marshall静脉 无水乙醇消融 阵发性心房颤动 导管射频消融 

分 类 号：R541[医药卫生—心血管疾病]