CAJ | 학술논문

目的了解环肺静脉电隔离消融与抗心律失常药物治疗阵发性心房颤动的疗效和对患者左心房大小的影响.方法 101例阵发性心房颤动患者分别采用环肺静脉电隔离消融与抗心律失常药物治疗,其中消融组56例,药物治疗组45例,应用超声心动图观察治疗前及治疗后12个月左房大小的变化.结果平均随访(14.6±2.3)个月,消融组维持窦性心律47例,成功率为83.9％;药物治疗组维持窦性心律22例,成功率为48.8％,消融组窦性心律的维持率明显高于药物治疗组,差异有统计学意义(P＜0.05).治疗前左心房大小相似,药物治疗成功组患者左房内径虽较治疗前有所减小,但差异无统计学意义(P＞0.05);消融成功组患者治疗后12个月左房内径较术前及药物治疗成功组均明显减小,差异有统计学意义(P＜0.05).结论环肺静脉电隔离消融是治疗阵发性心房颤动的有效方法,与药物治疗相比,有较高的窦律维持率,能更有效逆转左房结构重构.
목적 료해배폐정맥전격리소융여항심률실상약물치료진발성심방전동적료효화대환자좌심방대소적영향.방법 101례진발성심방전동환자분별채용배폐정맥전격리소융여항심률실상약물치료,기중소융조56례,약물치료조45례,응용초성심동도관찰치료전급치료후12개월좌방대소적변화.결과 평균수방(14.6±2.3)개월,소융조유지두성심률47례,성공솔위83.9％;약물치료조유지두성심률22례,성공솔위48.8％,소융조두성심률적유지솔명현고우약물치료조,차이유통계학의의(P＜0.05).치료전좌심방대소상사,약물치료성공조환자좌방내경수교치료전유소감소,단차이무통계학의의(P＞0.05);소융성공조환자치료후12개월좌방내경교술전급약물치료성공조균명현감소,차이유통계학의의(P＜0.05).결론 배폐정맥전격리소융시치료진발성심방전동적유효방법,여약물치료상비,유교고적두률유지솔,능경유효역전좌방결구중구.
Objective To investigate the different impacts of circumferential pulmonary vein isolation and antiarrhythmic drug therapy on effectiveness and size of left atrial in patients with paroxysmal atrial fibrillation(AF).Methods One hundred and one patients with paroxysmal AF were divided into two groups,radiofrequency catheter ablation group (n =56) and antiarrhythmic drug therapy group (n =45).Echocardiography was used to examine the left atrial inner diameters of these patients.The data were collected before therapy,and evaluated in 12 months after therapy.Results After a mean followup of (14.6 ± 2.3) months,47 patients were free from AF in radiofrequency catheter ablation group,the success rate was 83.9％ ; 22 patients were free from AF in drug treatment group,the success rate was 48.8％.The success rate of radiofrequency catheter ablation group was significantly higher than that of catheter ablation group (P ＜ 0.05).The left atrial inner diameters were similar in groups before therapy.Twelve months after therapy,there was no significant reduction in left atrial inner diametersin in patients who had sinus conversion by the antiarrhythmic drug procedure (P ＞ 0.05).In contrast,left atrial inner diametersins decreased significantly in patients who had sinus conversion by radiofrequency catheter ablation (P ＜ 0.05).Conclusions Circumferential pulmonary vein isolation is an effective therapy for paroxysmal AF.Compared with antiarrhythmic drug therapy,it has higher sinus conversion rate and can more effectively reverse morphological remodeling of the left atrial.