CAJ | 학술논문

目的：观察肺静脉电隔离术（ pulmonary vein isolation ， PVI ）联合碎裂电位（ complex fractionated atrial electrograms ， CFAE）消融对持续性房颤的疗效。方法对比观察23名于本院行房颤射频消融术的持续性房颤患者，所有患者均行PVI及左房顶部线性消融，其中12例联合CFAE消融，术后随访1年；观察两组手术时间、X线曝光时间、消融时间、手术并发症、左房大小、左房血栓、一次手术成功率等指标。结果联合CFAE消融组总手术时间（252±35） min、X线曝光时间（42±9．1）min、消融时间（94±11）min，单纯行PVI 组分别为（176±22）min、（34±7．6）min、（63±8）min，联合CFAE消融组手术各时间均明显延长（P＜0．01）；两组手术并发症、对左房大小及左房血栓的影响比较差异均无统计学意义；联合CFAE消融组一次手术成功率（75％）明显高于单纯行PVI组（64％）（ P＜0．05）。结论 PVI联合CFAE消融治疗持续性房颤虽增加手术、消融及X线曝光时间，但并不会提高并发症发生率，可提高房颤消融的一次手术成功率。
목적：관찰폐정맥전격리술（ pulmonary vein isolation ， PVI ）연합쇄렬전위（ complex fractionated atrial electrograms ， CFAE）소융대지속성방전적료효。방법대비관찰23명우본원행방전사빈소융술적지속성방전환자，소유환자균행PVI급좌방정부선성소융，기중12례연합CFAE소융，술후수방1년；관찰량조수술시간、X선폭광시간、소융시간、수술병발증、좌방대소、좌방혈전、일차수술성공솔등지표。결과연합CFAE소융조총수술시간（252±35） min、X선폭광시간（42±9．1）min、소융시간（94±11）min，단순행PVI 조분별위（176±22）min、（34±7．6）min、（63±8）min，연합CFAE소융조수술각시간균명현연장（P＜0．01）；량조수술병발증、대좌방대소급좌방혈전적영향비교차이균무통계학의의；연합CFAE소융조일차수술성공솔（75％）명현고우단순행PVI조（64％）（ P＜0．05）。결론 PVI연합CFAE소융치료지속성방전수증가수술、소융급X선폭광시간，단병불회제고병발증발생솔，가제고방전소융적일차수술성공솔。
Objective To observe the effects of pulmonary vein isolation ( PVI) associated with complex fractionated atrial electrograms ( CFAE) ablation on patients with persistent atrial fibrillation ( AF) .Methods Twenty-three patients with persistent AF were enrolled in the study .All of them had been treated by PVI and linear ablation in left atrium , among whom 12 cases were additionally given CFAE ablation .During a one-year follow-up, several indexes were compared between the two groups , including the duration of operation , X-ray exposure time , ablation time , surgical complica-tions, internal diameter and thrombus of left atrium , success rate of once operation , etc.Results Compared with PVI group, the total time of operation [(176 ±22) min vs.(252 ±35) min], X-ray exposure time[(34 ±7.6) min vs.(42 ±9.1) min], and ablation time[(63 ±8) min vs.(94 ± 11) min] was significantly increased in PVI +CFAE group ( P<0 .05 ) .The differences of surgical complications, and the influences on internal diameter and thrombus of left atrium were not statisti-cally significant .The success rate of once operation in PVI associated with CFAE ablation group was significantly higher than that in PVI group (75%vs.64%;P<0.05).Conclusion In the treat-ment of persistent atrial fibrillation , although PVI associated with CFAE ablation lengthens the time of operation , X-ray exposure time , and ablation time , it will not increase the incidence of complica-tions and can elevate the success rate of once operation in atrial fibrillation ablation .