CAJ | 학술논문

目的：评价强化肺静脉前庭前壁消融的环肺静脉隔离术联合上游药物治疗房颤的安全性及有效性。方法顺序入选2012年2月至2014年2月大连市中心医院59例房颤患者，阵发性房颤采用环肺静脉隔离术，持续性房颤采用环肺静脉隔离加左房顶部及二、三尖瓣峡部线消融。术中均强化肺静脉前庭前壁消融的时间及能量。上游治疗药物选用瑞舒伐他汀及替米沙坦。术后第1、3、6、12及18个月进行随访。结果随访（12±6）个月，联合治疗成功率为86．4％。治疗前后左房前后径[（45±7）mm比（41±5） mm，P＜0．05）]左房排空分数[（46％±4％）比（54％±5％），P＜0．05]，改善明显。结论强化肺静脉前庭前壁消融的环肺静脉隔离术联合上游药物治疗房颤安全可靠，治疗12个月后左心房内径减小、左心房排空指数增加。
목적：평개강화폐정맥전정전벽소융적배폐정맥격리술연합상유약물치료방전적안전성급유효성。방법순서입선2012년2월지2014년2월대련시중심의원59례방전환자，진발성방전채용배폐정맥격리술，지속성방전채용배폐정맥격리가좌방정부급이、삼첨판협부선소융。술중균강화폐정맥전정전벽소융적시간급능량。상유치료약물선용서서벌타정급체미사탄。술후제1、3、6、12급18개월진행수방。결과수방（12±6）개월，연합치료성공솔위86．4％。치료전후좌방전후경[（45±7）mm비（41±5） mm，P＜0．05）]좌방배공분수[（46％±4％）비（54％±5％），P＜0．05]，개선명현。결론강화폐정맥전정전벽소융적배폐정맥격리술연합상유약물치료방전안전가고，치료12개월후좌심방내경감소、좌심방배공지수증가。
Objective To report the safety, efficacy of anterior pulmonary vein vestibule intensive ablation and upstream therapy for atrial fibrillation ( AF ) .Methods AF patients ( n =59 ) undergone radiofrequency ablation were enrolled.The paroxysmal AF patients underwent circumferential pulmonary vein isolation ( CPVI).The persistent AF patients underwent CPVI plus linear ablation.During CPVI,the anterior pulmonary vein vestibule was performed intensively by prolonging the ablation time and increasing the ablation energy.Rosuvastatin and telmisartan were used for upstream therapy.The patients underwent follow-up at 1 month after ablation,and then at 3,6,12 and 18 months to evaluating whether the procedure is valid and safety.Results During the 12 ±6.5 months follow-up, the success rate of combination therapy was 86.4%.Preoperative and postoperative left atrial diameter was ( 45 ± 7 ) mm, and ( 41 ± 5 ) mm ( P<0.05),left atrial emptying fraction before operation was 46% ±4%,and 54% ±5%after operation (P<0.05).Conclusions Combination therapy is valid and safety to treat AF.The results of 12 months follow-up showed left atrial diameter was decreased and left atrial emptying fraction was increased.