肥厚型梗阻性心肌病合并心房颤动患者一站式导管射频消融治疗  

One-stage catheter ablation for atrial fibrillation in patients with hypertrophic obstructive cardiomyopathy

作　　者：刘晓霞 李松南[1] 常栋 梁斌[3] 马长生[1] Liu Xiaoxia;Li Songnan;Chang Dong;Liang Bin;Ma Changsheng(Department of Cardiology,Beijing Anzhen Hospital,Capital Medical University,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院心内科,100029 [2]厦门大学附属心血管病医院心内科 [3]山西医科大学第二医院心内科

出　　处：《中华老年心脑血管病杂志》2023年第7期692-695,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的探讨肥厚型梗阻性心肌病(HOCM)合并心房颤动(AF)患者一站式射频消融AF及室间隔的安全性及疗效。方法回顾性分析2018年1月至2021年12月来自3家医院接受一站式导管射频消融治疗的HOCM合并AF患者11例,记录围术期参数,术后随访窦性心律维持、左心室流出道压差(LVOTG)、左心房内径等参数变化以及症状改善情况。采用配对样本t检验比较超声心动图参数变化。结果11例患者均成功完成AF及室间隔射频消融术,术前左心房直径(45.0±4.0)mm,室间隔厚度(21.0±5.0)mm,静息LVOTG(81.0±21.0)mm Hg(1mm Hg=0.133kPa)。平均随访时间为13.9个月,随访期间有3例患者AF复发;左心房直径(43.0±6.0)mm,室间隔厚度(19.0±4.0)mm,静息LVOTG(35.0±27.0)mm Hg,静息LVOTG较术前显著减低(P<0.01)。术中及术后随访期间均未发生射频消融相关严重并发症。结论对于HOCM合并AF患者,一站式AF及室间隔导管射频消融治疗安全、有效。Objective To investigate the safety and efficacy of one-stop radiofrequency ablation of atrial fibrillation(AF)and interventricular septum in patients with hypertrophic obstructive cardiomyopathy(HOCM).Methods A retrospective trail was conducted on 11 patients with HOCM and AF who underwent one-stop radiofrequency ablation in 3 hospitals from June 2018 to December 2021.Their perioperative parameters were recorded,and the maintenance of sinus rhythm,left ventricular outflow tract pressure gradient(LVOTG),left atrial diameter and symptom improvement were followed up.Paired-samples t test was used to compare the changes of echocardiographic parameters.Results AF and septal ablation were successfully performed in all the 11 patients.The average follow-up time was 13.9 months,and AF recurrence occurred in 3 patients during the period.Significant declines were observed from preoperative to the end of follow-up in the left atrial diameter(45.0±4.0 mm to 43.0±6.0 mm),interventricular septal thickness(21.0±5.0 mm to 19.0±4.0 mm),and resting LVOTG[81.0±21.0 mm Hg(1 mm Hg=0.133 kPa)to 35.0±27.0 mm Hg,P<0.01].No serious complications related to radiofrequency ablation occurred during the operation and follow-up.Conclusion One-stage radiofrequency ablation of AF and interventricular septum is safe and effective for patients with HOCM complicated with AF.

关 键 词：心肌病 肥厚性 心房颤动 射频消融术 回顾性研究 

分 类 号：R542.2[医药卫生—心血管疾病] R541.75[医药卫生—内科学]