射频消融肺静脉电隔离术治疗阵发性房颤20例

Pulmonary venous isolation using radiofrequency ablation in 20 paroxysmal atrial fibrillation patients

目的观察电生理标测指导下肺静脉电隔离术治疗阵发性房颤的临床疗效。方法阵发性房颤患者20例,环状电极指示下对肺静脉行射频消融电隔离术。结果20例患者共接受心脏大静脉电隔离治疗28次(6例进行了第2次,1例进行了第3次),隔离静脉68根,肺静脉62根,上腔静脉6根,在房颤心律下消融58根,62根肺静脉中54根达到消触终点。平均操作时间和X线透视时间分别为(120±l8)min和(32±9)min。平均随访(5.0±2.3)个月,示13例无房颤发作、2例房颤发作明显减少,总有效率达75%。结论肺静脉电隔离术治疗阵发性房颤具有较好临床疗效。

Objective To evaluate the efficacy of electrophysiological mapping guided isolation of the pulmonary veins in patients with paroxysmal atrial fibrillation （PAF）. Methods Circular electrode mapping-guided isolation of the pulmonary vein was performed in 20 patients with PAF. Results 20 consecutive patients underwent 28 times of cardiac vena cava isolation, with 6 patients require repeai procedures and 1 case had 3 times for atrial fibrillation recurrence. Eletrical isolation was achieved in 62 pulmonary veins and 6 superior vena cavas （SVC）. Pulmonary veins isolation were performed in 58 during atrial fibrillation. Electrophysiological end point for catheter ablation was succeed in 54 of total 62 pulmonary veins. The mean duration of radiofrequencv delivery and fluoroscopy exposure were 120 ＋/-18 minutes and 32＋/-9minutes respectively.13 patients maintained sinus rhythm and 2 patients had significantly reduced atrial fibrillation episode after a mean follow-up of 5.0＋/-2.3 months and the success rate of this group is 75%. Conclusion Pulmonary vein isolation appears to be a feasible and safe approach for treating patients with PAF with a high rate of success.