23例微创双房消融路径治疗孤立性心房颤动的临床经验  

Clinical experience of bilateral atrial ablation with minimally invasive surgery for 23 cases with lone atrial fibrillation

作　　者：胡秋明[1] 吴凯胜 王盛宇[1] 曾文[1] 付金涛 郑帅[1] 孟斐[1] 张海波[1] 孟旭[1] 王坚刚[1] HU Qiuming;WU kaisheng;WANG Shengyu;ZENG Wen;FU Jintao;ZHENG Shuai;MENG Fei;ZHANG Haibo;MENG Xu;WANG Jiangang(Department of Vavular Surgery,Beijing Anzhen Hospital,Capital Medical University,Beijing Institute of Heart,Lung and Blood Vessel Diseases,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所、瓣膜外科中心,100029

出　　处：《心肺血管病杂志》2023年第3期252-256,共5页Journal of Cardiovascular and Pulmonary Diseases

基　　金：国家自然科学基金(82170311)。

摘　　要：目的:评价新型微创双房消融手术方法治疗孤立性心房颤动的安全性、有效性及可行性。方法:自2014年2月至2016年7月,对23例孤立性心房颤动患者施行了胸腔镜双房消融手术。纳入研究的患者包括抗心律失常药物治疗无效的、不能耐受药物且不合并其他器质性心脏病的、经导管射频消融术后复发的心房颤动患者,其中阵发性心房颤动患者8例(8/23,34.8%),持续性心房颤动15例(15/23,65.2%)。结果:所有患者手术过程顺利,术后随访至1年,无围手术死亡及卒中发生。术后随访窦性心律转复率:围手术期内23例(23/23,100%)患者成功转复窦律,术后3个月随访患者23例,所有患者均为窦性心律;术后6个月随访22例,21例(21/23,95.5%)为窦性心律,术后1年随访10例,9例(9/10,90%)为窦性心律,术后随访过程中无一例患者出现快速房性心律失常事件。结论:微创双房消融治疗孤立性心房颤动是安全有效的,使用双房消融线可增加术后窦性心律转复率,有效的减少术后快速房心律失常发生率,降低心房颤动复发率。Objective:The purpose of this study is to evaluate the safety,efficacy,and feasibility of bilateral atrial ablation for lone atrial fibrillation.Methods:23 patients with lone atrial fibrillation were treated with thoracoscopic bilateral atrial ablation in our center from February 2014 to July 2016.Patients in this study,all had lone atrial fibrillation(8 patients with paroxysmal atrial fibrillation,8/23,34.8%;and 15 patients with persistent atrial fibrillation,15/23,65.2%),including those who were unsatisfactory or intolerant to antiarrhythmic drug therapy,and those who suffered recurrence after transcatheter atrial fibrillation ablation.Results:The procedures were successful in all patients,none suffered death or stroke during the perioperative period.All patients(23/23,100%)were in sinus rhythm immediately after surgery and maintained to 3 months follow-up.22 patients were followed up for 6 months,and 95.5%(21/22)were in sinus rhythm.Then 10 patients were followed up for 1 year,and 9 of them stayed in sinus rhythm.No patients suffered from atrial tachycardia during follow-up. Conclusions: Thoracoscopic bilateral atrial ablation is a safe, effective, and feasible method to treat patients with lone atrial fibrillation. Bilateral atrial abl ation could increase the sinus rhythm reversal rate after surgery and reduce the atrial tachycardia rate.

关 键 词：心房颤动 导管消融术 微创外科 

分 类 号：R54[医药卫生—心血管疾病]