微波消融治疗心脏瓣膜疾病合并心房颤动初步探讨

Microwave ablation for patients suffering from valve diseases with sustained atrial fibrillation

目的 探讨外科微波消融治疗心脏瓣膜疾病合并持续性心房颤动 (AF)的方法。方法 回顾分析 4 9例心脏瓣膜疾病合并持续性AF病例 ,其中 2 5例行瓣膜置换同期微波治疗AF(治疗组 ) ,2 4例行瓣膜置换而未同期行微波治疗AF病人 (对照组 )的治疗结果和早期随访资料。结果 治疗组 2 2例术中恢复窦性心律 ,3例仍为AF ;2 5例随访 1～ 2 3个月 ,2例仍为AF ,1例术后第 12dAF复发 ,口服胺碘酮等药物治疗效果欠佳 ;总有效率为 88 .0 % (2 2 / 2 5例 )。对照组术后 3例转复为窦性心律 ,2 1例仍为持续性AF ,口服药物治疗疗效欠佳 ;2 3例随访 1～ 2 5个月 ,2例为窦性心律 ,窦性心律维持率 8. 3% (2 / 2 4例 ) ,两组相比差异有显著统计学意义 (P <0 . 0 5 )。结论 微波消融治疗瓣膜疾病合并持续性AF安全、可靠、疗效较为确切 ,但尚待循证医学进一步证实。

Objective To evaluate the early results of microwave ablation for patients suffering from valve diseases combined with sustained atrial fibrillation (AF). Methods The short term results were retrospectively analyzed in 25 patients with valve disease combined with sustained AF. 24 patients treated with valve replacement without ablation served as control group. Results In treated group, 22 cases recorded sinus rhythm, 3 remained in AF postoperatively. Follow-up 1～23 months, 22 maintained sinus rhythm. Total efficacy rate was 88%. In control group, 21 cases remained in AF. At a follow-up 1～25 months, only 2 cases (8.3%, 2/24) maintained a sinus rhythm. Difference was statistically significant (P<0.05). Conclusion Microwave ablation for AF is safe and reliable, but it still needs further confirmation.