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窦性冲动疏导术治疗心房颤动的长期随访研究

Analysis in terminating the multiple wavelets in atrial fibrillation
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摘要 目的观察窦性冲动疏导术治疗心房颤动的长期疗效。方法1996年5月至2002年6月,9例患者接受了窦性冲动疏导术,消除多子波折返激动。其中7例同时进行二尖瓣置换。术后对9例患者进行不定期随访,随访过程中,患者接受心电图,彩色超声心动图检测。结果2例于随访1后及1.5年后失访,其他7例患者随访7~13年。术后1年内心功能Ⅰ级5例,Ⅱ级4例;窦性心律2例,类窦性心律7例;Ⅲ度AV-B并发症1例,心肌病进展1例,肾功能不全1例;心房A/E峰为0.3者2例,0.4者4例,0.5者2例,0。6者1例。有6例于术后1~2周内先后出现过早搏、阵发陛室上性心动过速等心律失常,未服用抗心律失常药自行恢复规律的心律。结论窦性冲动疏导术是一种可以有效消除心房多子波折返激动的术式,消除了多子波折返激动就可以消除心房颤动。但是得到的却是一种永久性的室上心律。如果对这种单一的室上心律起搏点进行消融,失去了异位起搏点后可以得到的应该是窦性心律。 Objective To analyze the termination of the multiple wavelets to stop the atrial fibrillation (AF). Methods Nine patients accepted sinus impulse dredging procedure, among them 7 were mitral valve replacement (MVR). These patients were followed up for 1-13 years by electrocardiogram and echocardiography for the heart rhythm and kick function of the left atrium atrial fibdllatian. Results Seven patients were followed up for 7-13 years. Among all patients, there were cardiac function level Ⅰin 5 cases, level Ⅱ in 4 eases, sinus rhythm in 2 cases, class sinus rhythm in 7 cases, AV-B Complication level Ⅲin 1 case, cardiomyopathy progress in 1 case and renal insufficiency in 1 case. The value of atrial A/E peak was 0.3 in 2 cases, 0.4 in 4 cases, 0.5 in 2 cases and 0.6 in 1 case. There were premature or paroxysmal supraventricular tachycardia of the number 2, 4, 6, 7, 8, 9 patients in 1 - 2 weeks. Conclusions Sinus impulse dredging procedure is an effective operation to terminate the multiple wavelets. If the multiple wavelets are terminated, the atrial fibriUatlon will be cured. But the rhythm is permanent super ventricular rhythm after sinus impulse dredging procedure. There may be arrhythmia originating from the same bursting point.
作者 刘永春 颜均
出处 《中国医药》 2011年第11期1302-1304,共3页 China Medicine
关键词 心房颤动 窦性冲动疏导术 多子波折返激动 室上性心动过速 Atrial fibrillation Sinus impulse dredging procedure Multiple wavelets Supraventrlcular tachycardia
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