射频消融迷宫手术联合应用可达龙治疗风心病房颤的对比研究

Contrastive study of radiofrequency ablation Maze procedure combined with amiodarone for treating atrial fibrillation of rheumatic heart disease(RHD)

目的对比研究射频消融迷宫手术联合应用可达龙治疗风心病房颤的窦性心律转复率及其影响因素。方法射频消融迷宫手术组病人在瓣膜手术时行射频消融迷宫手术,术中术后应用可达龙;对照组在瓣膜手术时不行射频消融迷宫手术,但同样应用可达龙,观察两组病人的窦性心律转复率,并分析其影响因素。结果射频消融迷宫手术组窦性心律转复率为77.5%,对照组为6.1%,两组间有明显差异(P<0.01)。术前病人左房内径小、房颤时间短者有利于窦性心律的转复,而术前射血分数、肺动脉收缩压、心功能分级、心胸比对其无明显影响;射频消融迷宫手术后,即使没有恢复窦性心律的病人其室性心率也比术前明显降低。结论射频消融迷宫手术对治疗风心病房颤效果令人满意,对左房内径小、房颤时间短者效果更好。

Objective： To study the sinus rhythm restoring rate of RHD patients after treated by radiofrequency ablation Maze procedure combined with Amiodarone and compare with those treated only with amiodarone. Methods： All patients in the two groups were undergone valve surgeries. Patients in the test group were also undergone radiofrequency ablation Maze procedure combined with Amiodarone. And patients in the contrast group were only treated with Amiodarone. The sinus rhythm restoring rates were recorded and the affecting factors were analyzed. Results： The sinus rhythm restoring rates of the test and contrast groups were respectively 77.5% and 6.1%. There were significant differences between the two groups （ P 〈 0.01 ）. Sinus rhythm was easily resotred in the patients with small left atrium and short term of atrial fibrillation. And ejecting fraction（ EF）, pulmanary artery pressure （PAP）, heart function class grade, cardio-thoracic-ratio were not the affecting factors. The postoperative heart rates were also significantly lower than the preoperative in patients whose sinus rhythm was not restored after radiofrequency ablation Maze procedure. Conclusion： Radiofrequency ablation Maze procedure for atrial fibrillation of RHD patients can achieve satisfied sinus rhythm restoring rate. And more satisfied results can be achieved in the patients with small left atrium and short term of atrial fibrillation .