左束支区域起搏联合房室结消融治疗长程持续性心房颤动合并心力衰竭的老年患者  

The effectiveness of left bundle branch area pacing combined with atrioventricular node ablation with long-term continuous atrial fibrillation and heart failure in elderly patients

作　　者：朱广辉 罗剑锋 郭飞 朱静 徐若辰 张梦娟 徐健 ZHU Guang-hui;LUO Jian-feng;GUO Fei;ZHU Jing;XU Ruo-chen;ZHANG Meng-juan;XU Jian(Department of Cardiology,Anhui Provincial Hospital Affiliated to Anhui Medical University,Hefei 230001,Anhui,China)

机构地区：[1]安徽医科大学附属省立医院心血管内科,安徽合肥230001

出　　处：《中国心脏起搏与心电生理杂志》2024年第1期18-21,共4页Chinese Journal of Cardiac Pacing and Electrophysiology

基　　金：温州市科学技术局基础科研项目(Y20220462)。

摘　　要：目的评估左束支区域起搏联合房室结消融(LBBAP+AVNA)对长程持续性心房颤动(简称房颤)合并心力衰竭(简称心衰)的老年患者的疗效。方法连续性纳入长程持续性房颤合并心衰行LBBAP+AVNA或单纯房颤射频消融(RFA)的老年患者共64例,根据纳排标准,最终入选30例;根据术式不同分为LBBAP+AVNA组(n=9)和RFA组(n=21)。比较两组患者术后6个月疗效,评估LBBAP+AVNA的有效性。结果术后6个月随访,与RFA组相比,LBBAP+AVNA组左房前后径较大(48 mm比42 mm,P=0.037)、NYHA分级较低(2级比3级,P=0.001)、再住院率较低(11.1%比52.4%,P=0.049)。与术前相比,LBBAP+AVNA组NYHA分级降低(2级比3级,P=0.011)。结论LBBAP+AVNA治疗长程持续性房颤合并心衰的老年患者具有可行性。Objective To evaluate the effectiveness of the left bundle branch area pacing combined with atrioventricular node ablation(LBBAP+AVNA) in the treatment of long-standing persistent atrial fibrillation(AF) combined with heart failure(HF) in elderly patients.Methods A total of 64 elderly patients with long-standing persistent AF combined with HF were consecutively enrolled in either LBBAP+AVNA or sole atrial fibrillation radiofrequency ablation(RFA) procedures.After applying exclusion criteria,30 patients were ultimately selected.Patients were divided into two groups based on the procedure:the LBBAP+AVNA group(n=9) and the RFA group(n=21).The treatment outcomes were compared between the two groups at the 6-month follow-up to evaluate the effectiveness of LBBAP+AVNA.Results At the 6-month post-operative follow-up,compared to the RFA group,the LBBAP+AVNA group had a larger left atrial diameter(48 mm vs 42 mm,P=0.037),lower NYHA classification(2 vs 3,P=0.001),and a lower readmission rate(11.1% vs 52.4%,P=0.049).In comparison to preoperative assessments,the NYHA classification in the LBBAP+AVNA group had decreased(2 vs 3,P=0.011).Conclusions LBBAP+AVNA is a feasible treatment for long-standing persistent AF combined with HF in elderly patients.[Chinese Journal of Cardiac Pacing and Electrophysiology,2024,38(1):18-21]

关 键 词：心血管病学 长程持续性心房颤动 心力衰竭 左束支区域起搏 射频消融 房室结消融 

分 类 号：R541.75[医药卫生—心血管疾病] R541.61[医药卫生—内科学] R454.1[医药卫生—临床医学]