肺静脉口节段性电隔离消融术治疗对房颤患者左房功能及预后复发的影响  

Effect of segmental electrical isolation ablation on left atrial function and prognosis of patients with atrial fibrillation

作　　者：高曙光 杨蕙毓 邹培培 Gao Shu-guang;Yang Hui-yu;Zou Pei-pei(Department of Catheter,The First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450000,China)

机构地区：[1]河南中医药大学第一附属医院导管室,河南郑州450000

出　　处：《四川生理科学杂志》2024年第12期2636-2638,2793,共4页

摘　　要：目的:探讨经导管射频消融治疗对房颤(Atrial fibrillation,AF)患者的左房功能及预后复发的影响。方法:回顾性收集2020年1月~2023年3月期间在本院进行诊治的134例AF患者的临床资料。根据治疗方案的不同将患者分为对照组(给予环肺静脉消融术,61例)与观察组(肺静脉口节段性电隔离,73例)。分析比较两组的左房功能[左房前后径(LAD)、左室射血分数(LVEF)、左房面积(LA area),左室舒张晚期(A)和舒张早期(E)心肌组织运动峰速]、窦性心律维持率、复发情况以及并发症。结果:治疗前,两组的LAD、LVEF、LA area、A、E未见明显差异(P>0.05)。治疗后3 m,两组的LAD、LA area均降低,且观察组的LAD、LA area均显著低于对照组。治疗后3 m,两组的LVEF、A均升高,且观察组的LVEF、A均显著高于对照组(P<0.05);两组的E未见明显差异(P>0.05)。治疗后3m,治疗后6m,观察组的窦性心律维持率均比治疗前呈上升趋势,且观察组的窦性心律维持率均显著高于对照组(P<0.05)。治疗后1 y,观察组的总复发率显著低于对照组(P<0.05)。两组的并发症发生率无显著差异(P>0.05)。结论:肺静脉口节段性电隔离消融术能改善左房功能,提高窦性心律维持率,降低复发率,且安全性较高。Objective:To investigate the effect of transcatheter radiofrequency ablation on left atrial function and prognosis in patients with atrial fibrillation(AF).Methods:The clinical data of 134 AF patients treated in our hospital from January 2020 to March 2023 were retrospectively collected.The patients were divided into control group(61 cases)and observation group(73 cases)according to different treatment regiments.Left atrial function[Left anterior and posterior atrium diameter(LAD),left ventricular ejection fraction(LVEF),left atrial area(LA area),peak velocity of myocardial tissue movement in late diastolic(A)and early diastolic(E)],sinus rhythm maintenance rate,recurrence and complications were analyzed and compared between the two groups.Results:Before treatment,there were no significant differences in LAD,LVEF,LA area,A and E between the two groups(P>0.05).At 3 months after treatment,the LAD and LA area of both groups decreased,and the LAD and LA area of the observation group were significantly lower than those of the control group.At 3 months after treatment,LVEF and A were increased in both groups,and LVEF and A in observation group were significantly higher than those in control group(P<0.05).There was no significant difference in E between the two groups(P>0.05).At 3 months after treatment and 6 months after treatment,the sinus rhythm maintenance rate in the observation group showed an increasing trend compared with before treatment,and the sinus rhythm maintenance rate in the observation group was significantly higher than that in the control group(P<0.05).One year after treatment,the total recurrence rate in the observation group was significantly lower than that in the control group(P<0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusion:Segmental electrical isolation ablation of pulmonary venous orifice can improve left atrial function,increase sinus rhythm maintenance rate,reduce recurrence rate,and is safe.

关 键 词：经导管射频消融 房颤 左房功能 复发率 并发症 

分 类 号：R541.75[医药卫生—心血管疾病]