射频消融术治疗慢性房颤后左室功能的变化

Changes of Left Ventricular Function after Radiofrequency Ablation for the Treatment of Chronic Atrial Fibrillation

[目的]评价导管射频消融术治疗慢性心房颤动后左室功能的变化.[方法]83例慢性房颤患者随机分配到药物治疗组或射频消融术治疗组.药物治疗组38例,平均年龄（53.2±8.9）岁,射频消融术治疗组45例,平均年龄（52.7±9.0）岁.分别于治疗前及治疗后第3、6个月随访,复查心电图、24 h动态心电图及超声心动图,评估患者的左房左室内径、左室射血分数、NYHA分级.[结果]射频消融组45例患者均实现肺静脉电隔离,在术后3个月的随访中,9例复发,单次消融成功率为 80%.9例复发患者中3例接受再次消融并成功,消融总成功率为86.7%.患者的左房内径、左室内径明显减小 左室射血分数显著增加 NYHA分级提高.[结论]环肺静脉线性消融治疗慢性心房颤动疗效好,术后患者左房、左室缩小,心功能增强.

[Objective]To evaluate the changes of left ventricular function after radiofrequency ablation for the treatment of chronic atrial fibrillation. [Methods]A total of 83 patients with chronic atrial fibrillation were randomly assigned to drug treatment group（the control group） or radiofrequeney ablation group. There were 38 patients aged 53.2±8. 9 years old in the drug treatment group. There were 45 patients aged 52. 7±9.0 years old in radiofrequency ablation group. The patients were followed up for 3 -6 months before and after treatment. Electrocardiogram（ECG） , 24h dynamic ECG（DCG） and echoeardiogram（UCG） were reexamined. The inner diameter of left atria and left ventricle, left ventricular ejection fraction（LVEF） and NYHA grading were evaluated. [Results] Circumferential pulmonary vein ablation succeeded in 45 patients in radiofrequency ablation group. Among them, 9 patients recurred during 3 month follow-up after operation. The achievement ratio for the first time was 80%. Of 9 relapse patients, 3 patients received ablation again and succeeded. The total achievement ratio was 86.7%. After patients received radiofrequency ablation, the inner diameter of left atria and left ventricle diminished, and I.VEF increased significantly, andthe grade of NYHA improved. [Con elusion] Circumferential pulmonary vein ablation for the treatment of chronic atrial fibrillation has good effect. After ablation, left atria and left ventricular of patients are diminished and cardiac function is improved.