CAJ | 학술논문

目的对导管消融治疗阵发性心房颤动(房颤)合并窦房结功能障碍植入永久起搏器治疗的患者进行分析,比较传统心电图记录判断房颤复发率与起搏器程控记录模式转换事件判断房颤复发率有无差别.方法所有患者因阵发性房颤接受导管消融治疗,因合并病态窦房结综合征于导管消融前后植入双腔起搏器治疗.消融术后3个月随访开始记录房颤发作情况.分别通过传统记录方式(心电图、24 h动态心电图)和起搏器程控记录(模式转换事件)判断房颤复发情况.结果共40例(男28例)患者纳入研究,平均年龄(46.00±9.37)岁,左心室射血分数0.52 ～0.73 (0.61±0.03),左心房内径31.00 ～38.00(34.00±6.56)mm,随访4.5～42.0(25.0±8.2)个月.随访结束时,38例患者维持窦性心律.根据临床症状、心电图、24 h动态心电图诊断房颤复发10例(25％)；根据起搏器程控记录房颤复发16例(40％).结论合并病态窦房结综合征的阵发性房颤患者,需要植入永久起搏器.导管消融术后根据心电图和起搏器腔内电图判断房颤的复发率有无差别.
목적 대도관소융치료진발성심방전동(방전)합병두방결공능장애식입영구기박기치료적환자진행분석,비교전통심전도기록판단방전복발솔여기박기정공기록모식전환사건판단방전복발솔유무차별.방법 소유환자인진발성방전접수도관소융치료,인합병병태두방결종합정우도관소융전후식입쌍강기박기치료.소융술후3개월수방개시기록방전발작정황.분별통과전통기록방식(심전도、24 h동태심전도)화기박기정공기록(모식전환사건)판단방전복발정황.결과 공40례(남28례)환자납입연구,평균년령(46.00±9.37)세,좌심실사혈분수0.52 ～0.73 (0.61±0.03),좌심방내경31.00 ～38.00(34.00±6.56)mm,수방4.5～42.0(25.0±8.2)개월.수방결속시,38례환자유지두성심률.근거림상증상、심전도、24 h동태심전도진단방전복발10례(25％)；근거기박기정공기록방전복발16례(40％).결론 합병병태두방결종합정적진발성방전환자,수요식입영구기박기.도관소융술후근거심전도화기박기강내전도판단방전적복발솔유무차별.
Objective To describe the difference of atrial fibrillation(AF) recurrence rate of paroxysmal AF in patients with pacemaker implantation and to compare electrocardiogram(ECG) Holter and pacemaker auto mode switch recordings after catheter ablation.Methods All of the patients received catheter ablation and pacemaker implantation because of paroxysmal AF and sick sinus syndrome.The follow-up began at the third month after catheter ablation.The recurrence rate of AF after catheter ablation was judged by two methods:the recordings of ECG or Holter and the recordings of auto mode switch in dual chamber pacemaker.Results Forty patients (28 males) underwent catheter ablation for parosxymal AF,average age was (46.00±9.37) years,with left ventricular ejection fraction 0.52 ～ 0.73 (0.61 ±0.03),and left atrial dimension 31.00 ～ 38.00 (34.00 ±6.56)mm.Thirty-eight patients (95％)maintained sinus rhythm at the end of the follow-up.Ten patients (25％) were detected recurrence of AF through ECG/Holter recordings after catheter ablation,and 16 patients (40％) were detected recurrence of AF through pacemaker auto mode switch recording after catheter ablation.Conclusions The patients suffered paroxyomal AF with sick sinus syndrome should be implanted pacemaker for slow arrhythmia no matter whether receiving catheter ablation.There was difference in recurrence of AF after catheter ablation the recordings of ECG/Holter and auto mode swithrecordings.