瓣膜置换同时射频消融隔离肺静脉口治疗风湿性心脏病心房颤动的临床研究

Pulmonary vein isolation using radiofrequency ablation for atrial fibrillation in patients undergoing rheumatic valvular heart surgery.

目的 探讨心内直视下射频消融隔离肺静脉口治疗风湿性心脏病心房颤动的可行性及临床疗效。方法 选择风湿性心脏病心房颤动患者 5 8例 ,于瓣膜置换术中同时射频消融隔离肺静脉口。结果 5 0例术后即刻转为窦性心律 ,8例仍为心房颤动 ,术后 1周 6例由窦性心律转为持续性心房颤动 ,2例心房颤动恢复窦性心律。 5 2例出院后随访 3～ 2 4个月 ,4 0例维持窦性心律 ,成功率为 77%。结论 心内直视下射频消融隔离肺静脉口治疗风湿性心脏病心房颤动有较好疗效 ,且方法简单 ,并发症少。

Objective To evaluate the safety and efficiency of pulmonary vein isolation using radiofre- quency ablationto treat atrial fibrillation in patients with rheumatic valvular disease.Method Radiofrequency catheter ablation were performed daring heart valve surgery in 58 patients with rheumatic valvular disease and atrial fibrillation (AF).The amiodarone was given before and after the surgery. Results Sinus rhythm restored in 50 patients(86.2%) immediately after the operation,either spontaneously or after intraoperative direct current cardioversion,but 8 patients still had atrial fibrillation.AF was recurred in 6 patients a week later.Two of eight patients with AF restored to sinus rhythm before hospital discharge.52 patients reached 3 to 24 months of followed-up,40 of 52 patients (77%) remained in sinus rhythm.Conclusions Pulmonary vein isolation using radiofrequency is safe and effective in restoration and maintenance of sinus rhythm in patients with rheumatic valvular disease and AF.