射频消融术治疗不同左心室射血分数心力衰竭合并持续性心房颤动的效果  

Effect of radiofrequency ablation on different left ventricular ejection fraction heart failure with persistent atrial fibrillation

作　　者：尹遇冬[1] 马琳 赵晓旭 辛宾宾 陈滢伊 逯保军[1] 高爱玲[1] 郑海军[1] Yin Yudong;Ma Lin;Zhao Xiaoxu;Xin Binbin;Chen Yingyi;Lu Baojun;Gao Ailing;Zheng Haijun(Department of Cardiovascular Medicine,the People's Hospital of Jiaozuo,Jiaozuo 454000,China)

机构地区：[1]河南省焦作市人民医院心血管内科,454000

出　　处：《临床医学》2024年第9期12-16,共5页Clinical Medicine

摘　　要：目的探讨射频消融术治疗不同左心室射血分数(LVEF)心力衰竭(HF)合并持续性心房颤动(AF)的疗效。方法选择2018年10月至2022年10月于焦作市人民医院心血管内科行射频消融术的60例HF合并持续性AF患者为研究对象。按照LVEF分为R组(LVEF<40%,n=32)与M组(40%≤LVEF<50%,n=28)。比较两组美国纽约心脏病学会(NYHA)心功能分级、心功能指标[LVEF、左心房前后径(LAD)、左室舒张末径(LVEDd)、6 min步行距离(6MWD)、N末端脑钠肽前体(NT⁃proBNP)]、心脏瓣膜变化情况(二尖瓣反流、三尖瓣反流)、术中事件(电复律、HF急性发作、其他房性心律失常、脑血管事件)、再住院及复发情况。结果治疗后,两组NYHA分级均低于治疗前,差异有统计学意义(P<0.05),但两组比较差异未见统计学意义(P>0.05)。治疗后,两组LVEF、6MWD水平均显著高于治疗前,LAD、LVEDd及NT⁃proBNP水平均显著低于治疗前,差异有统计学意义(P<0.05);但治疗前后两组比较差异未见统计学意义(P>0.05)。治疗6个月后,两组二尖瓣反流及三尖瓣反流明显减轻,差异有统计学意义(P<0.05),但两组比较差异未见统计学意义(P>0.05)。R组术中HF急性发作及其他房性心律失常发生率明显高于M组,差异有统计学意义(P<0.05)。两组术中电复律及脑血管事件发生率、治疗后6个月及1年的再住院率及复发率比较,差异均未见统计学意义(P>0.05)。结论射频消融术对不同LVEF心力衰竭合并持续性AF患者的治疗效果显著,有助于改善心脏结构及功能,改善症状及预后,但LVEF<40%的患者术中HF急性发作和房性心律失常发生风险相对较高。Objective To investigate the efficacy of radiofrequency ablation on different left ventricular ejection fraction(LVEF)heart failure(HF)with persistent atrial fibrillation(AF).Methods Sixty patients with HF with persistent AF who underwent radiofrequency ablation in the cardiovascular Department of Jiaozuo People's Hospital from October 2018 to October 2022 were selected as the study objects.According to LVEF,they were divided into group R(LVEF<40%,n=32)and group M(40%≤LVEF<50%,n=28).The cardiac function grades according to New York College of Cardiology(NYHA),cardiac function indexes[LVEF,left atrial anterior and posterior diameter(LAD),left ventricular end diastolic diameter(LVEDd),6 minute walking distance(6MWD),N⁃terminal brain natriuretic peptide precursor(NT⁃proBNP)],heart valve changes(mitral regurgitation,tricuspid regurgitation),intraoperative events(electrical cardioversion,HF episodes,other atrial arrhythmias,cerebrovascular events),re⁃hospitalization,and recurrence were compared between the two groups.Results After treatment,NYHA grades in both groups were lower than those before treatment,with significant differences(P<0.05),but there was no significant difference between the two groups(P>0.05).After treatment,the levels of LVEF and 6MWD were significantly higher than those before treatment,the levels of LAD,LVEDd and NT⁃proBNP were significantly lower than those before treatment,with significant differences(P<0.05).There was no significant difference between the two groups before and after treatment(P>0.05).After 6 months of treatment,mitral valve regurgitation and tricuspid valve regurgitation were significantly reduced in the two groups,the differences were significant(P<0.05),but there was no significant difference between the two groups(P>0.05).The incidence of HF acute attack and atrial arrhythmia in group R was significantly higher than that in group M,and the differences were significant(P<0.05).There was no significant difference in the incidence of electrocardioversion and cerebrov

关 键 词：心力衰竭 心房颤动 射频消融术 左心室射血分数 

分 类 号：R541.75[医药卫生—心血管疾病] R541.6[医药卫生—内科学]