CAJ | 학술논문

目的观察在心脏瓣膜置换术中同期行双极射频消融术治疗心房颤动（A F ）的疗效及安全性。方法回顾性分析自2007年4月至2010年8月在瓣膜置换术同期行双极射频消融术治疗A F患者70例的临床资料。全组在全麻开胸直视体外循环下行双极射频消融术＋瓣膜置换术。结果70例患者全部存活，术后当天心电图提示：64例患者心律均由 A F转为窦性心律，3例结性心律，2例顽固室性心动过速，1例Ⅲ度房室传导阻滞。随访3～40个月无一例死亡，61例维持窦性心律，占87．1％；6例房颤心律，占8．6％；3例房扑心律，占4．3％。结论双极射频消融术治疗RHD合并AF ，可使绝大多数病人恢复窦性心律，是一种安全的值得推广的好方法。
목적관찰재심장판막치환술중동기행쌍겁사빈소융술치료심방전동（A F ）적료효급안전성。방법회고성분석자2007년4월지2010년8월재판막치환술동기행쌍겁사빈소융술치료A F환자70례적림상자료。전조재전마개흉직시체외순배하행쌍겁사빈소융술＋판막치환술。결과70례환자전부존활，술후당천심전도제시：64례환자심률균유 A F전위두성심률，3례결성심률，2례완고실성심동과속，1례Ⅲ도방실전도조체。수방3～40개월무일례사망，61례유지두성심률，점87．1％；6례방전심률，점8．6％；3례방복심률，점4．3％。결론쌍겁사빈소융술치료RHD합병AF ，가사절대다수병인회복두성심률，시일충안전적치득추엄적호방법。
Objective To observe effect and safety of bipolar radiofrequency ablation for atrial fi-brillation (AF) in the course of heart valve replacement .Methods Retrospectively analyze the clinical data from April 2007 to August 2010 ,70 cases of rheumatic heart disease (RHD) with AF received bipolar radiofrequency ablation for atrial fibrillation (AF) in the course of heart valve replacement . There were 24 Male and 46 female .The age ranges was from 28 years to 69 years .Among them ,Mi-tral valve replacement was 25 cases ,Aortic valve replacement was 5 cases ,Mitral and aortic valve re-placement was 32 cases ,and mitral and aortic and tricuspid valve replacement was 8 cases .Results There were no perioperational mortality .The follow-up ranging was from 3 months to 40 months ,pa-tients were survived after operation ,the postoperative complications acute cardiac perforation/pressure plug1 case ,coronary artery ischemia 2 cases .The electrocardiogram was represented that the cardiac rhythm of 61 patients turn from AF to sinus rhythm ,3 cases were nodal rhythm ,2 cases were stub-born ventricular tachycardia .1 case was Ⅲ atrioventricular block .In the following 3 ~40 months , there was no death .61 cases kept sinus rhythm and were account for 87 .1% .Six cases were atrial fi-brillation rhythm were 8 .6% .3 cases were atrial flutter rhythm and accounted for 4 .3% .Conclusion Bipolar radiofrequency ablation for atrial fibrillation (AF) in the course of heart valve replacement is a safe and effective therapeutic method .