CAJ | 학술논문

目的分析迷走型和交感型心房颤动(房颤)的临床特点并采用环肺静脉消融进行治疗,对其方法学及疗效进行评价.方法接受环肺静脉消融的连续192例阵发性房颤患者,根据房颤发作特点分为迷走型房颤组(n=25)和交感型房颤组(n=18),其余病例归为对照组(n=139),对3组病例的临床特点进行分析,采用环肺静脉消融进行治疗达到电隔离,对其疗效进行比较.结果迷走型房颤多在夜间、休息时或进食后发生,交感型房颤多在白天、运动和情绪激动后发生.前者平均年龄相对年轻[(52±6)岁对(67±4)岁,P＜0.05],环肺静脉消融后随访(21.2±11.4)个月,迷走型房颤组、交感型房颤组和对照组成功率分别为88.0％、83.3％和84.6％,3组成功率差异无统计学意义.结论迷走型和交感型房颤作为房颤的特殊类型表明自主神经系统参与房颤的发生,采用环肺静脉消融能取得满意的治疗效果.
목적 분석미주형화교감형심방전동(방전)적림상특점병채용배폐정맥소융진행치료,대기방법학급료효진행평개.방법 접수배폐정맥소융적련속192례진발성방전환자,근거방전발작특점분위미주형방전조(n=25)화교감형방전조(n=18),기여병례귀위대조조(n=139),대3조병례적림상특점진행분석,채용배폐정맥소융진행치료체도전격리,대기료효진행비교.결과 미주형방전다재야간、휴식시혹진식후발생,교감형방전다재백천、운동화정서격동후발생.전자평균년령상대년경[(52±6)세대(67±4)세,P＜0.05],배폐정맥소융후수방(21.2±11.4)개월,미주형방전조、교감형방전조화대조조성공솔분별위88.0％、83.3％화84.6％,3조성공솔차이무통계학의의.결론 미주형화교감형방전작위방전적특수류형표명자주신경계통삼여방전적발생,채용배폐정맥소융능취득만의적치료효과.
Objective To explore the clinical characteristic of vagal and sympathetic atrial fibrillation (AF) and to evaluate the effectiveness of circumferential pulmonary vein ablation(CPVA).Methods One hundred and ninety-two consecutive patients underwent CPVA due to paroxysmal AF were enrolled.According to the clinical characteristic of AF onset,twenty-five patients were diagnosed as vagal AF and eighteen patients were diagnosed as sympathetic AF,the remaining were classified into control group( n =139).CPVA were performed in all cases to achieved pulmonary vein isolation and the ablation success rate in thee groups were comparable.Results Vagal AF occurred during night and the most common vagal triggers were sleep and postprandial.Sympathetic AF occurred in daylight and the most common triggers were emotional or physical stress and exercise.The patients in group of vagal AF were younger than those in sympathetic AF group,(52±6 )years vs.(67±4)years,P＜0.05.CPVA was equally effective in all three groups,indeed,the ablation success rate during a mean follow-up of(21.2±11.4) months was 88.0％,83.3％ and 84.6％ in vagal AF,sympathetic AF and control groups,respectively.Conclusion Vagal and sympathetic atrial fibrillation as a special pattern of AF shown that cardiac autonomic nervous system involved in the occurrence of AF and the effective treatment of CPVA can achieve satisfied clinical results.