风湿性二尖瓣狭窄伴心房纤颤球囊二尖瓣成形术后心房纤颤的复律治疗

Cardioversion treatment in patients with rheumatic mitral stenosis and atrial fibrillation after percutaneous balloon mitral valvuloplasty

报道９０例风湿性二尖瓣狭窄伴心房纤颤（简称二狭房颤）球囊二尖瓣成形术（ＰＢＭＶ）后复律治疗的结果。８９例患者在ＰＢＭＶ后２周内接受复律治疗，１５例服用奎尼丁后恢复窦性心律，７４例经体表电复律转为窦性心律。随访２３．５±１１．７个月，２４例（２７％）患者心房纤颤复发。我们认为心房纤颤病程长，ＰＢＭＶ后瓣口面积小和左房回缩差是心房纤颤复发的可能原因。

Ninety patients with rheumatic mitral stenosis and atrial fibrillation received cardioversion treatment after percutaneous balloon mitral valvuloplasty (PBMV). 89 of them were converted to sinus rhythm with oral quinidine ( 15 cases) or current electrical defibrillation (74 cases) within 2 weeks after PBMV. During the follow up period (23.5±11 7months), 24 patients had recurrence of atrial fibrillation. It was considered that longer atrial fibrillation history, small mitral area and higher left atrial pressure after PBMV were the key factors of atrial fibrillation recurrence.