心房颤动病史和心房大小与射频迷宫术疗效的关系

The Influence of Atrial Remodeling on the Effect of Radiofrequency Ablation Maze Procedure.

报道风湿性心脏病 (RHD)慢性心房颤动 (AF) 6 6例射频迷宫手术治疗AF的结果 ,通过探讨病史长短和左房大小对射频迷宫手术疗效的影响 ,试述心房重构对AF治疗的影响。手术后恢复窦性心律 (恢复组 )患者和未恢复窦性心律 (未恢复组 )患者AF病史长短和左房大小有显著差异 (3.84± 3.2 4vs 11.13± 8.74年 ,6 6 .17± 9.88vs81.83± 12 .85mm ,P均 <0 .0 1)。AF病史越长手术效果越差 ,AF病史 >3年的患者AF转复率明显低于AF病史 <3年者(72 .5 %vs 96 .2 % ,P <0 .0 1) ;左房越大手术效果越差 ,左房最大直径 >70mm患者AF转复率明显低于 <70mm的患者 (6 1.5 %vs 95 % ,P <0 .0 1)。AF病史长短和左房大小明显影响射频迷宫手术的疗效 。

In order to study the influence of atrial remodeling on the effect of radiofrequency ablation maze procedure in treating chronic atrial fibrillation(AF) in patients of rheumatic heart disease,the relationship between the result of the procedure and the duration of AF and the largest dimention of left atrium was analysed.The difference of the AF duration and the largest left atrium dimention betweem patients who restored to sinus rhythm and those who didn′t was significant(3.84±3.24 vs 11.13±8.74 year and 66.17±9.88 vs 81.83±12.85 mm, P<0.01 respectively).The longer was the AF duration and the larger was the left atrium,the worse was the effect of the procedure.The difference between the percentage of patients who restored to sinus rhythm between patients whose AF duration>3 year and those whose AF duration<3 year was significant(72.5% vs 96.2%, P< 0.01 ).The difference between the percentage of patients who restored to sinus rhythm between patients whose largest left atrium>70 mm and those<70 mm was significant(61.5% vs 95%, P<0.01 ).Atrial remodeling has a notable negative influence on the effect of radiofrequency ablation maze procedure.