CAJ | 학술논문

目的：观察环肺静脉消融电隔离术治疗阵发性心房颤动（房颤），术中出现去迷走效应（vagal denervation，VD）对疗效的影响。方法对50例阵发性房颤患者行环肺静脉射频消融术（RFA）治疗，消融终点为肺静脉电隔离，将术中出现去迷走效应并进行消融的房颤患者列为 VD 阳性组（19例），余患者列为 VD 阴性组（31例）。观察比较两组患者术后6个月房颤的复发率。结果50例均达消融终点，术后6个月，VD 阳性组疗效明显高于 VD 阴性组（84．21%比64．511%，P ≤0．05）。结论环肺静脉消融术治疗房颤过程中发生去迷走效应可明显提高房颤 RFA 的的成功率。
목적：관찰배폐정맥소융전격리술치료진발성심방전동（방전），술중출현거미주효응（vagal denervation，VD）대료효적영향。방법대50례진발성방전환자행배폐정맥사빈소융술（RFA）치료，소융종점위폐정맥전격리，장술중출현거미주효응병진행소융적방전환자렬위 VD 양성조（19례），여환자렬위 VD 음성조（31례）。관찰비교량조환자술후6개월방전적복발솔。결과50례균체소융종점，술후6개월，VD 양성조료효명현고우 VD 음성조（84．21%비64．511%，P ≤0．05）。결론배폐정맥소융술치료방전과정중발생거미주효응가명현제고방전 RFA 적적성공솔。
Objective To evaluate the impact of vagal denervation (VD) that is derived from circumferential ablation of pulmonary vein ostium for paroxysmal atrial fibrillation (AF) on the therapeutic results. Methods A total of 50 patients with paroxysmal atrial fibrillation were enrolled in this study. Circumferential ablation of pulmonary vein ostium was carried out in all the patients. The end point of ablation was pulmonary vein electricity isolation. The patients in whom VD occurred during the performance of ablation were regarded as VD- positive group (n = 19), and the remaining patients were used as VD- negative group (n = 31). The recurrence rate of AF six months after the treatment was recorded, and the results were compared between the two groups. Results The end point of ablation was successfully achieved in all the fifty cases. Six months after the ablation, the therapeutic effect of VD- positive group was significantly better than that of VD- negative group (84.21% vs 64.51%, P ≤ 0.05). Conclusion The vagal denervation effect that is derived from circumferential ablation of pulmonary vein ostium in treating AF can significantly increase the success rate of radiofrequency ablation for AF.