CAJ | 학술논문

目的总结三维标测系统(CARTO)指导下逐级消融策略治疗非阵发性心房颤动(房颤)的临床效果及可能机制.方法 40例非阵发性房颤患者接受逐级消融手术,第一步行环肺静脉前庭电学隔离术(PVAI),未复律者继续行线性消融,仍未复律者再继续行碎裂电位消融,直至复律或电复律.术后随访6～18个月.结果 40例患者PVAI后有11例转为窦性心律,线性消融后11例转为窦性心律,碎裂电位消融后6例转为窦性心律,其余行电复律.术后复发4例房颤,2例心房扑动,3例房性心动过速,以单纯PVAI后明显.结论三维标测系统指导下采用逐级消融策略治疗非阵发性房颤是安全可靠的;单纯PVAI,成功率低,且易复发.
목적 총결삼유표측계통(CARTO)지도하축급소융책략치료비진발성심방전동(방전)적림상효과급가능궤제.방법 40례비진발성방전환자접수축급소융수술,제일보행배폐정맥전정전학격리술(PVAI),미복률자계속행선성소융,잉미복률자재계속행쇄렬전위소융,직지복률혹전복률.술후수방6～18개월.결과 40례환자PVAI후유11례전위두성심률,선성소융후11례전위두성심률,쇄렬전위소융후6례전위두성심률,기여행전복률.술후복발4례방전,2례심방복동,3례방성심동과속,이단순PVAI후명현.결론 삼유표측계통지도하채용축급소융책략치료비진발성방전시안전가고적;단순PVAI,성공솔저,차역복발.
Objective To investigate the efficacy of CARTO-guided stepwise ablation approaches for treatment of patients with nonparoxysmal atrial fibrillation(AF). Methods Stepwise ablation approaches were performed in 40 patients with nonparoxysmal atrial fibrillation. Pulmonary vein atrium isolation (PVAI), linear ablation in atria, complex fractionated atrial electrograms (CFAEs) ablation and cardioversion were applied sequentially till sinus rhythm (SR) restoration. All patients were followed up 6 to 18 months. Results SR was restored in 11 patients after PVAI, in 11 patients after linear ablation and in 6 patients after CFEAs ablation. SR was restored in the remaining 13 patients post cardioversion. During follow-up,3 atrial fibrillation, 3 atrial tachycardia and 5 atrial flutter were evidenced. Seven out of the 11 patients with reoccurred arrhythmia were treated only by PVAI. Conclusions CARTO-guided stepwise ablation approaches are safe and effective in the treatment of patients with nonparoxysmal atrial fribrillation. PVAI approach was associated with lower successful rate and high recurrence rate.