导管消融治疗持续性房颤合并心力衰竭患者的效果分析

Efficacy of catheter ablation for persistent atrial fibrillation in patients with heart failure

目的评价导管消融治疗持续性房颤合并心力衰竭患者的疗效。方法回顾性分析收治的持续性房颤合并心力衰竭的患者共106例,54例为对照组,52例为观察组(导管消融+药物治疗),治疗后12月随访,观察两组N末端脑钠肽前体(NT-proBNP)、左房内径(LAD)、左室舒张末期内径(LVEDD)、左心室射血分数(LVEF)、NYHA心功能分级、6分钟步行距离(6MWD)、心衰恶化。结果治疗前两组患者NT-proBNP、LAD、LVEDD、LVEF、NYHA心功能分级及6MWD水平比较差异无统计学意义(P>0.05),随访12个月观察组LVEF、6MWD高于对照组(P<0.05),LAD、LVEDD、NT-proBNP、心衰恶化低于对照组(P<0.05),NYHA心功能分级较对照组明显改善(P<0.05)。结论导管消融治疗持续性房颤合并心力衰竭患者的疗效肯定,恢复窦性节律后逆转心房心室重构,改善心功能,降低患者心衰恶化的发生,改善患者预后。

Objective To study the clinical efficacy of catheter ablation for persistent atrial fibrillation(AF)in patients with heart failure(HF).Methods A retrospective analysis of 106 patients with persistent AF complicated with HF were enrolled.52 patients were in the observation group,with catheter ablation and medical therapy,and 54 patients were in the control group,with medical therapy.NT-proBNP and cardiac parameters were collected and regularly followed up within 12 months.Results Before treatment,NT-pro BNP,LVEF,LVEDD,LAD,and 6 MWD levels were compared between two groups,there was no significant difference(P>0.05).After treatment,the total effective rate of the observation group was significantly higher than those in the control group.LVEF and 6 MWD were significantly higher in the observation group than those in the control group;and LVEDD,LAD,NTpro BNP were significantly lower than those in the control group(P<0.05).Conclusion Catheter ablation is effective in the treatment of patients with persistent atrial fibrillation complicated with heart failure.It can reverse atrial and ventricular remodeling after the recovery of sinus rhythm,improve cardiac function,reduce the occurrence of worsening heart failure and improve the prognosis of patients.