环肺静脉隔离联合左心房顶部线性消融治疗阵发性心房颤动的临床效果
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摘要
目的研究环肺静脉隔离联合左心房顶部线性消融治疗阵发性心房颤动的效果。方法选取2016年1月～2017年12月我院收治的50例阵发性心房颤动患者作为研究对象,根据治疗方式的不同,将其分为观察组和对照组,每组各25例。对照组患者实施环肺静脉隔离治疗,观察组患者实施环肺静脉隔离联合左心房顶部线性消融治疗。比较两组患者的消融成功率、并发症发生情况、心脏形态和功能。结果观察组患者的消融成功率(92.00%)高于对照组(68.00%),差异有统计学意义(P<0.05)。两组患者的并发症发生率比较,差异无统计学意义(P>0.05)。治疗6个月后,两组患者的左心房前后径(LAD)、右心房前后径(RAD)明显低于治疗前,而左室射血分数(LVEF)明显高于治疗前,差异均有统计学意义(P<0.05)。治疗6个月后,观察组患者的LAD、RAD明显低于对照组,而LVEF明显高于对照组,差异有统计学意义(P<0.05)。结论环肺静脉隔离联合左心房顶部线性消融治疗阵发性心房颤动患者的消融成功率比环肺静脉隔离高,可改善患者心脏形态和功能,且安全性高。
Objective To study the effect of circumferential pulmonary vein isolation combined with linear left atrial ablation for paroxysmal atrial fibrillation. Methods Fifty patients with paroxysmal atrial fibrillation admitted to our hospital from January 2016 to December 2017 were selected as subjects and were divided into observation group and control group according to the different treatment methods, 25 cases in each group. The control group was treated with circumferential pulmonary vein isolation, while the observation group was treated with circumferential pulmonary vein isolation combined with linear ablation of the left atrium. The success rate of ablation, complications, cardiac morphology and function were compared between the two groups. Results The success rate of ablation in the observation group(92.00%) was higher than that in the control group(68.00%), and the difference was statistically significant(P<0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05). After 6 months of treatment, the left atrial diameter(LAD) and right atrial anteroposterior diameter(RAD) of the two groups were significantly lower than those before the treatment, and the left ventricular ejection fraction(LVEF) was significantly higher than that before the treatment, and the differences were statistically significant(P<0.05). After 6 months of treatment,the LAD and RAD in the observation group were significantly lower than those in the control group, while LVEF was significantly higher than that in the control group, and the differences were statistically significant(P<0.05). Conclusion In the treatment of patients with paroxysmal atrial fibrillation, the success rate of ablation of circumferential pulmonary vein isolation combined with left atrial top ablation is higher than that of the circumferential pulmonary vein,which can improve the shape and function of the heart and is safe.
Objective To study the effect of circumferential pulmonary vein isolation combined with linear left atrial ablation for paroxysmal atrial fibrillation. Methods Fifty patients with paroxysmal atrial fibrillation admitted to our hospital from January 2016 to December 2017 were selected as subjects and were divided into observation group and control group according to the different treatment methods, 25 cases in each group. The control group was treated with circumferential pulmonary vein isolation, while the observation group was treated with circumferential pulmonary vein isolation combined with linear ablation of the left atrium. The success rate of ablation, complications, cardiac morphology and function were compared between the two groups. Results The success rate of ablation in the observation group(92.00%) was higher than that in the control group(68.00%), and the difference was statistically significant(P<0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05). After 6 months of treatment, the left atrial diameter(LAD) and right atrial anteroposterior diameter(RAD) of the two groups were significantly lower than those before the treatment, and the left ventricular ejection fraction(LVEF) was significantly higher than that before the treatment, and the differences were statistically significant(P<0.05). After 6 months of treatment,the LAD and RAD in the observation group were significantly lower than those in the control group, while LVEF was significantly higher than that in the control group, and the differences were statistically significant(P<0.05). Conclusion In the treatment of patients with paroxysmal atrial fibrillation, the success rate of ablation of circumferential pulmonary vein isolation combined with left atrial top ablation is higher than that of the circumferential pulmonary vein,which can improve the shape and function of the heart and is safe.
引文
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[11]刘韵情,李铁军,马淑梅,等.导管射频消融术治疗心房颤动127例临床分析[J].中国医师进修杂志,2014,37(34):23-25.
[12]郑元喜,辜和平,程静芳.30例房颤射频消融术的临床研究[J].中国现代医生,2014,52(30):156-157.
[13]黄琼,袁义强,王瑞敏.房颤射频消融术对阵发性房颤患者心脏形态和功能的影响[J].中国继续医学教育,2015,7(9):31-32.
[14]谭琛,徐威,胡雪红,等.不同性别行导管射频消融治疗心房颤动的有效性和安全性差异[J].中国循证心血管医学杂志,2013,5(6):627-629.
[15]陈建华,张飞龙,陈学海,等.射频消融术对老年高血压合并阵发性心房颤动患者左心重构的影响[J].临床心血管病杂志,2014,30(8):673-676.
[16]刘飞,徐健,严激.射频消融术对心肌病阵发性心房颤动患者心脏逆重构的影响[J].安徽医科大学学报,2015,50(2):223-226.
[2]高迎春,赵平,贺利平.阵发性房颤经导管射频消融与药物治疗的对比评价[J].中国循证心血管医学杂志,2014,6(5):555-557.
[3]冯丽芸,宋旭东,刘磊,等.两种心脏导管射频消融术式治疗阵发性心房颤动的疗效比较[J].山东医药,2017,57(30):60-63.
[4]袁鹏,毕齐.心房颤动患者心脏导管射频消融术后急性缺血性脑卒中发病率及其影响因素研究[J].中国全科医学,2016,19(20):2399-2405.
[5]徐健,苏浩,陈康玉,等.阵发房颤合并病窦综合征的射频消融治疗[J].临床心电学杂志,2016,25(2):102-104.
[6]张其银,惠杰,刘明,等.75岁以上老年阵发性心房颤动患者导管射频消融的安全性和有效性分析[J].中国循环杂志,2016,31(S1):48.
[7]王劲风,杨浩,汪祥海,等.Cart03系统指导下阵发性房颤导管射频消融疗效观察[C]//安徽省医学会心血管病分会.安徽省第十六次心血管学术年会论文汇编.合肥:2013.
[8]李庆宽,覃绍明,卢志红,等.导管射频消融治疗房颤36例临床分析[J].中国临床新医学,2016,9(10):888-891.
[9]张其银.导管射频消融治疗阵发性房颤伴快—慢综合征的疗效分析[D].苏州:苏州大学,2016.
[10]司华峰.经导管射频消融术对不同类型的房颤患者的疗效观察[D].郑州:郑州大学,2014.
[11]刘韵情,李铁军,马淑梅,等.导管射频消融术治疗心房颤动127例临床分析[J].中国医师进修杂志,2014,37(34):23-25.
[12]郑元喜,辜和平,程静芳.30例房颤射频消融术的临床研究[J].中国现代医生,2014,52(30):156-157.
[13]黄琼,袁义强,王瑞敏.房颤射频消融术对阵发性房颤患者心脏形态和功能的影响[J].中国继续医学教育,2015,7(9):31-32.
[14]谭琛,徐威,胡雪红,等.不同性别行导管射频消融治疗心房颤动的有效性和安全性差异[J].中国循证心血管医学杂志,2013,5(6):627-629.
[15]陈建华,张飞龙,陈学海,等.射频消融术对老年高血压合并阵发性心房颤动患者左心重构的影响[J].临床心血管病杂志,2014,30(8):673-676.
[16]刘飞,徐健,严激.射频消融术对心肌病阵发性心房颤动患者心脏逆重构的影响[J].安徽医科大学学报,2015,50(2):223-226.