体外循环手术同期改良迷宫射频消融治疗心脏疾病合并持续性心房颤动的临床研究  

Clinical study on the simultaneous modified Maze-IV during extracorporeal circulation surgery treating heart disease complicated with persistent atrial fibrillation

作　　者：李晖[1] 刘长城[1] 李海洋[1] LI Hui;LIU Changcheng;LI Haiyang(Department of Cardiac Surgery,Beijing Anzhen Hospital,Capital University,Beijing Institute of Heart,Lung and Blood Vederses 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心脏外科,100029

出　　处：《心肺血管病杂志》2024年第6期618-622,共5页Journal of Cardiovascular and Pulmonary Diseases

基　　金：北京医院管理局临床医学发展专项基金(XMLX202107)。

摘　　要：目的:探究体外循环手术同期改良迷宫心房颤动射频消融术(COX-Maze IV,CMIV)治疗心脏疾病合并持续性心房颤动的有效性和对左心房功能的影响。方法:回顾性分析2016年1月至2023年8月,我科治疗的235例持续性心房颤动合并其他需体外循环手术患者的临床资料,患者均接受同期改良CMIV手术。男性68例、女性167例,评均年龄(51.5±6.7)岁,心房颤动病程中位数4年。术后随访12个月,观察患者窦性心律恢复及左心房功能恢复情况。结果:235例患者均顺利完成手术,出院前心房颤动转为窦性心律或交界性心律占206例(90.0%),194例(84.7%)恢复左心房功能,平均A波速度(37.6±11.4)cm/s。术后12个月随访,维持窦性心律及左心房功能恢复患者分别占82.7%和80.1%。结论:体外循环手术同期改良CMIV治疗心脏疾病合并持续性心房颤动是有效的,且有助于左心房功能恢复。Objective:To investigate the effectiveness of modified COX-Maze IV(CMIV)during extracorporeal circulation surgery in the treatment of heart disease complicated with persistent atrial fibrillation and its impact on left atrial function.Methods:From January 2016 to August 2023,a retrospective analysis was conducted on the clinical data of 235 patients with persistent atrial fibrillation complicated with heart diseases.All patients underwent modified CMIV procedure during the extracorporeal circulation surgery.There are 68 males and 167 females,aged(51.5±6.7)years,with the median course of atrial fibrillation of 4 years.The recovery of sinus rhythm and left atrial function of patients are observed after 12 months of postoperation.Results:All 235 patients successfully completed the surgery.206 cases(90.0%)had atrial fibrillation converted to sinus or junctional rhythm before discharge,and 194 cases(84.7%)had left atrial function restored.The average A-wave velocity was(37.6±11.4)cm/s.After 12 months of follow-up,82.7%of patients maintained sinus rhythm and 80.1%recovered left atrial function,respectively.Conclusions:The simultaneous modified CMIV procedure during extracorporeal circulation surgery is effective in treating heart disease complicated with persistent atrial fibrillation and contributes to the recovery of left atrial function.

关 键 词：心房颤动 改良迷宫房颤射频消融手术 左心房功能 体外循环手术 

分 类 号：R54[医药卫生—心血管疾病]