三维标测环肺静脉前庭隔离术后肺静脉狭窄的相关因素

The Correlation Factors of Pulmonary Vein Stenosis Complicating Pulmonary Vein Antrum Isolation Guiding by 3D Mapping System for Atrial Fibrillation

目的：探讨房颤射频消融术后肺静脉狭窄的相关因素，为其预防提供依据。方法：收集113例射频消融房颤患者的临床资料，记录射频术中消融时间、阻抗和温度；术后6个月64层CT左房-肺静脉重建随访，统计肺静脉狭窄的发生率；多元Logistic回归分析肺静脉狭窄的相关因素。结果：依据肺静脉数量计算的肺静脉狭窄率为3．4％，按照患者数量计算的肺静脉狭窄率为7．7％。多元Logistic回归分析，初始50例手术较其后病例的OR为2．167，95％CI=I．038-9．857，P=0．046，消融时间在总消融时间均数之上的患者比在均数之下者OR为2．856，95％CI=1．352-6．043，P=0．021。结论：初始50例手术和消融时间长是房颤射频消融术后肺静脉狭窄的相关因素。

Objective： To explore what are the correlation factors of pulmonary vein stenosis following radiofrequency ablation guiding by 3D mapping system for atrial fibrillation in order to offer evidence for pulmonary vein stenosis prevention. Methods： The clinical data of 113 consecutive patients with atrial fibrillation underwent pulmonary vein antrum isolation guiding by 3D mapping（Carto） systerm were collected and the radiofrequency time, impedance and temperature during the index procedure were also recorded for analyzing. The prevalence of pulmonary vein stenosis was calculated according to the pulmonary vein diameter detected by 64-slice CT reconstruction in 6 months follow-up. The possible correlation factors were evaluated using multivariate Logistic regression analysis. Results： The pulmonary vein stenosis occurred in 6 out of 104 patients（7.7%）, whereas, the frequency of pulmonary vein stenosis was of 3.4% according to the amount of pulmonary vein. Multivariate Logistic regression analysis indicated pulmonary vein stenosis was more likely occurred in initial 50 cases （OR=2.167, 95% CI=1.038-9.857 ,P=0.046） and in patients with longer radiofrequency time（OR=2.856, 95% CI=1.352~6.043 ,P=0.021）. Conclusion： Initial 50 cases and longer radiofrequency time are the correlation factors of of pulmonary vein stenosis complicating radioffequency ablation guiding by 3D mapping system for atrial fibrillation.