不同线性射频消融治疗持续性心房颤动患者的临床效果比较  

Comparison of clinical effects of different linear radiofrequency ablation in the treatment of patients with persistent atrial fibrillation

作　　者：赵钰 马艳艳 王典博 ZHAO Yu;MA Yanyan;WANG Dianbo(Cardiovascular Medicine Department,Puyang Oilfield General Hospital,Puyang 457001;Emergency Department,Zhumadian TCM Hospital,Zhumadian 463400,China)

机构地区：[1]濮阳油田总医院心血管内科,河南濮阳457001 [2]驻马店市中医院急诊科,河南驻马店463400

出　　处：《临床医学研究与实践》2024年第8期64-67,共4页Clinical Research and Practice

摘　　要：目的比较不同线性射频消融治疗持续性心房颤动(AF)患者的临床效果。方法选择79例持续性AF患者为研究对象,根据消融术式不同将其分为内膜面组[51例,环肺静脉电隔离(CPVI)+左房顶部线+冠状窦内膜面]和2C3L组(28例,CPVI+左房顶部线+二尖瓣峡部线+三尖瓣峡部线)。比较两组患者的手术时间、左室射血分数(LVEF)、左心房收缩末期前后径(LAD)、心房脑钠肽(BNP)水平及AF复发率。结果2C3L组的手术时间长于内膜面组(P<0.05)。内膜面组的LVEF随着时间的延长基本呈现逐渐升高趋势,而2C3L组变化不明显,两组间比较,差异具有统计学意义(P<0.05)。术后3、6个月,2C3L组的LAD小于内膜面组(P<0.05)。术前及术后1、3、6个月,两组的BNP水平比较,差异无统计学意义(P>0.05)。术后3、6个月,两组的AF复发率比较,差异无统计学意义(P>0.05)。结论CPVI基础上的左房顶部线+冠状窦内膜面消融提高持续性AF患者术后LVEF的效果更明显,而2C3L术式可明显减小患者的术后LAD。Objective To compare the clinical effects of different linear radiofrequency ablation in the treatment of patients with persistent atrial fibrillation(AF).Methods A total of 79 patients with persistent AF were selected as the study objects.According to different ablation methods,the patients were divided into intimal surface group[51 cases,circumferential pulmonary vein isolation(CPVI)+left atrial top line+coronary sinus intimal surface]and 2C3L group(28 cases,CPVI+left atrial top line+mitral isthmus line+tricuspid isthmus line).The operation time,left ventricular ejection fraction(LVEF),left atrial end-systolic diameter(LAD),brain natriuretic peptide(BNP)level and AF recurrence rate were compared between the two groups.Results The operation time of the 2C3L group was longer than that of the intimal surface group(P<0.05).The LVEF in the intimal surface group basically showed a gradual increasing trend with the prolongation of time,while the change was not obvious in the 2C3L group,and the difference was statistically significant between the two groups(P<0.05).At 3 and 6 months after operation,the LAD in the 2C3L group was lower than that in the intimal surface group(P<0.05).There was no significant difference in BNP level between the two groups before operation and at 1,3 and 6 months after operation(P>0.05).At 3 and 6 months after operation,there was no significant difference in AF recurrence rate between the two groups(P>0.05).Conclusion Left atrial top line+coronary sinus intimal surface ablation on the basis of CPVI is more effective in improving postoperative LVEF in patients with persistent AF,while 2C3L procedure can significantly reduce postoperative LAD of patients.

关 键 词：持续性心房颤动 射频消融术 线性消融 复发率 

分 类 号：R541.7[医药卫生—心血管疾病]