中国经导管消融治疗心房颤动注册研究-2007

A report from registered catheter ablation of atrial fibrillation in China-2007

目的分析2007年我国经导管消融治疗心房颤动（房颤）工作的现状。方法根据各家医院提供的资料，对2007年我国导管消融治疗房颤病例资料进行回顾性分析。结果截至2008年9月5日，调查共收到40家医院提供的注册登记病例资料2620份，其中男性1719例，女性901例，平均年龄（58．5±11．2）岁。阵发性房颤77．4％，持续性房颤15．7％，长期持续性房颤6．9％。54．1％的患者合并1种或1种以上的基础心脏疾病。左心房内径（38．3±6．3）mm，左心室舒张末期内径（47．8±5．2）mm，左心室射血分数0．63±0．08。经导管消融治疗房颤的主要术式是环肺静脉消融术和环肺静脉消融加必要心房辅助线。消融能源主要为射频，占99．8％。2007年的消融成功率为80．3％，复发率为19．7％。对成功率和复发率有显著影响的因素有左心房内径、房颤类型和消融术式。术后抗心律失常药物的应用有所增多，抗凝治疗明显加强。总的并发症发生率为1．7％，无严重并发症如心房食管瘘和肺静脉狭窄发生。结论建议在相关条件较好的医院，可将经导管消融作为症状明显的阵发性房颤的一线治疗方法。

Objective To report the outcome of registe^-xl cathered catheter ablation of atrial fibrillation （AF） in China 2007. Methods Data on AF ablation from registered hospitals in 2007 was analyzed retrospectively. Results A total of 2620 cases from 40 hospitals wererecruied, male 1719, female 901, mean age 58. 5 ±11.2years. Proportions of patients with paroxysmal, long-standing permanent AF were 77.4%, 15.7% and 6. 9%, respectively. Patients accompanied with underlying disease were 54. 1%. Left atrial diameter was （38. 3 ± 6. 3 ） mm,left ventricular end-diastolic dimension was（47. 8 ± 5.2）mm, and left ventricular ejection fraction was 0. 63±0. 08. The most common prcedures were circumferential pulmonary veins （PV） ablation and circumferential PV ablation plus additional lines. The most often used ablation energy was radiofrequency （99. 8% ）. Total success rate was 80. 3% ,and recurrence rate was 19. 7%. Factors impacting success and rencurrence rates included left atrial diameter ,type of AF, and procedures. After catheter ablation, antiarrhythmic drug application increased moderately, and the anticoagulation therapy stengthened. Complications occurred in 26 patients （ 1.7% ）, no severe coplications such as esophagus atrail fistula and pulmonary vein stenosis were observed. Conclusions The catheter ablation could be recommended as a first-line therapy for patients with symptomatic paroxsmal AF in qualified hospitals.