CAJ | 학술논문

目的对比单纯肺静脉消融及与盒式消融治疗孤立性心房颤动(房颤)的疗效.方法 2010年6月至2012年11月,80例孤立性房颤患者行外科房颤射频消融手术,其中阵发性房颤33例,47例持续性房颤.术中均同期切除左心耳及处理Marshall韧带.37例患者在双侧肺静脉隔离(PVI)的基础上增加左心房后壁两条消融径线,形成盒式消融(Box)径线,其中14例为阵发性房颤,23例为持续性房颤.术后对患者进行随访.结果随访(18.8±7.4)个月,2例非心源性死亡.总窦性心率转复率78.8％,其中阵发性房颤窦性率87.9％,持续性房颤窦性率72.3％.在随访时间超过2年的患者中,阵发性房颤患者接受单纯PVI与Box消融的窦性转复率分别为84.6％ (11/13)和92.9％ (13/14),P=0.45;持续性房颤患者接受单纯PVI与Box消融的窦性率分别为58.3％ (14/24)和87.5％ (14/16),P=0.04.结论增加左心房后壁的消融径线,可以提高孤立性房颤的治愈率,尤其对持续性房颤的效果有明显的提高.
목적 대비단순폐정맥소융급여합식소융치료고립성심방전동(방전)적료효.방법 2010년6월지2012년11월,80례고립성방전환자행외과방전사빈소융수술,기중진발성방전33례,47례지속성방전.술중균동기절제좌심이급처리Marshall인대.37례환자재쌍측폐정맥격리(PVI)적기출상증가좌심방후벽량조소융경선,형성합식소융(Box)경선,기중14례위진발성방전,23례위지속성방전.술후대환자진행수방.결과 수방(18.8±7.4)개월,2례비심원성사망.총두성심솔전복솔78.8％,기중진발성방전두성솔87.9％,지속성방전두성솔72.3％.재수방시간초과2년적환자중,진발성방전환자접수단순PVI여Box소융적두성전복솔분별위84.6％ (11/13)화92.9％ (13/14),P=0.45;지속성방전환자접수단순PVI여Box소융적두성솔분별위58.3％ (14/24)화87.5％ (14/16),P=0.04.결론 증가좌심방후벽적소융경선,가이제고고립성방전적치유솔,우기대지속성방전적효과유명현적제고.
Objective To compare the mid-term results of video-assisted pulmonary veins isolation and box-lesion for lone atrial fibrillation.Methods Between June 2010 to November 2012,80 lone atrial fibrillation(LAF) patients underwent minimally invasive surgical ablation in Beijing Anzhen Hospital,and all of them received left atrial appendage excision and Marshall ligament break in the surgery.Among them,37 cases were performed two epicardial ablation lines in order to created box-lesion based on PVI(14 paroxysmal AF and 23 persistent AF).Follow-up was finished after discharge.Results Mean follow-up was(18.8 ± 7.4) months,and 2 patients were died with non-cardiac disease.The success rate is 78.8％ (Paroxysmal AF 87.9％;Persistent AF 72.3％).In the paroxysmal AF patients,the success rate for PVI and Box lesion treatment was 84.6％ (11/13) and 92.9％ (13/14),P =0.45;in the persistent AF patients,the success rate for PVI and Box-lesion was 58.3％ (14/24) and 87.5％ (14/16),P =0.04.Conclusion Addition of epicedial ablation lines might increase the cure rate for lone AF therapy,especially for persistent AF.