中华心律失常学杂志
中華心律失常學雜誌
중화심률실상학잡지
CHINESE JOURNAL OF CARDIAC ARRHYTHMIAS
2012年
5期
341-344
,共4页
孙育民%居维竹%陈明龙%杨兵%张凤祥%陈红武%林亚洲%余金波%张林忠%曹克将
孫育民%居維竹%陳明龍%楊兵%張鳳祥%陳紅武%林亞洲%餘金波%張林忠%曹剋將
손육민%거유죽%진명룡%양병%장봉상%진홍무%림아주%여금파%장림충%조극장
电生理学%心房颤动%导管消融%肺静脉%电隔离
電生理學%心房顫動%導管消融%肺靜脈%電隔離
전생이학%심방전동%도관소융%폐정맥%전격리
Electrophysiology%Atrial fibrillation%Catheter ablation%Pulmonary vein%Isolation
目的 评价以左心房-肺静脉电联系双向阻滞作为环肺静脉消融电隔离术终点对阵发性心房颤动(房颤)导管消融疗效的影响.方法 在76例阵发性房颤患者导管消融达到左心房-肺静脉传入阻滞后,分别于每根肺静脉内起搏评价肺静脉-左心房传导情况.据此分为双向阻滞组(传入与传出均阻滞)和传入阻滞组,随访观察房颤导管消融的临床疗效.结果 76例均完成导管消融术,306根肺静脉(2例患者存在右中肺静脉)均达到左心房-肺静脉电学传入阻滞之传统终点.18例消融术后左心房-肺静脉传导呈双向阻滞,58例仅传入阻滞.平均随访(6.85±1.08)个月,1次消融成功率为77.63％.其中,双向阻滞组为83.33％,传入阻滞组为75.86％,两组相比差异无统计学意义(P＞0.05).术后房性心动过速发生率5.26％(4/76),无心脏压塞、脑栓塞、左心房食管瘘等并发症以及死亡发生.结论 以左心房-肺静脉传导双向阻滞为房颤导管消融终点治疗阵发性房颤的策略似乎临床疗效较好.
目的 評價以左心房-肺靜脈電聯繫雙嚮阻滯作為環肺靜脈消融電隔離術終點對陣髮性心房顫動(房顫)導管消融療效的影響.方法 在76例陣髮性房顫患者導管消融達到左心房-肺靜脈傳入阻滯後,分彆于每根肺靜脈內起搏評價肺靜脈-左心房傳導情況.據此分為雙嚮阻滯組(傳入與傳齣均阻滯)和傳入阻滯組,隨訪觀察房顫導管消融的臨床療效.結果 76例均完成導管消融術,306根肺靜脈(2例患者存在右中肺靜脈)均達到左心房-肺靜脈電學傳入阻滯之傳統終點.18例消融術後左心房-肺靜脈傳導呈雙嚮阻滯,58例僅傳入阻滯.平均隨訪(6.85±1.08)箇月,1次消融成功率為77.63％.其中,雙嚮阻滯組為83.33％,傳入阻滯組為75.86％,兩組相比差異無統計學意義(P＞0.05).術後房性心動過速髮生率5.26％(4/76),無心髒壓塞、腦栓塞、左心房食管瘺等併髮癥以及死亡髮生.結論 以左心房-肺靜脈傳導雙嚮阻滯為房顫導管消融終點治療陣髮性房顫的策略似乎臨床療效較好.
목적 평개이좌심방-폐정맥전련계쌍향조체작위배폐정맥소융전격리술종점대진발성심방전동(방전)도관소융료효적영향.방법 재76례진발성방전환자도관소융체도좌심방-폐정맥전입조체후,분별우매근폐정맥내기박평개폐정맥-좌심방전도정황.거차분위쌍향조체조(전입여전출균조체)화전입조체조,수방관찰방전도관소융적림상료효.결과 76례균완성도관소융술,306근폐정맥(2례환자존재우중폐정맥)균체도좌심방-폐정맥전학전입조체지전통종점.18례소융술후좌심방-폐정맥전도정쌍향조체,58례부전입조체.평균수방(6.85±1.08)개월,1차소융성공솔위77.63％.기중,쌍향조체조위83.33％,전입조체조위75.86％,량조상비차이무통계학의의(P＞0.05).술후방성심동과속발생솔5.26％(4/76),무심장압새、뇌전새、좌심방식관루등병발증이급사망발생.결론 이좌심방-폐정맥전도쌍향조체위방전도관소융종점치료진발성방전적책략사호림상료효교호.
Objective To investigate the efficacy of catheter ablation for paroxysmal atrial fibrillation (AF) by using an endpoint of left atrium (LA)-pulmonary vein (PV)bi-directional electrical block.Methods Seventy-six patients with paroxysmal AF underwent circumferential PV ablation(CPVA) were divided into bi-directional block group(BDB group) and entrance block group(EB group) by pacing within PVs after achievement an routine endpoint of LA-PV entrance block,then to follow up these patients and evaluate the clinical efficacy of catheter ablation between the two groups.Results All 306 PVs of 76 patients were isolated and LA-PV entrance block were achieved.The LA-PV bi-directional block(BDB group)was achieved in 18 patients,the other 58 patients had only entrance block(EB group).After a mean follow-up of(6.85±1.08)months,the total success rate was 77.63％ by a single ablation procedure and atrial tachycardias were recorded in 5.26％ (4/76)patients.83.33％ of patients in BDB group and 75.86％ of patients in EB group were freedom from symptomatic AF without antiarrhythmic drugs.There was no significant differences between the two groups(P＞0.05).No severe complications such as cardiac tamponade,cerebral embolism,atrio-esophageal fistula,or death occurred in all patients.Conclusions The use of LA-PV bi-directional block as an electrophysiological endpoint may improve results of CPVA for paroxysmal AF.
