仿外科迷宫术射频消融长期持续性心房颤动中期随访结果

Catheter ablation of long-standing persistent atrial fibrillation medium term effects of imitation the surgery maze procedure ablation strategy

目的探讨仿外科迷宫术消融长期持续性心房颤动(LS-AF)的疗效。方法仿外科迷宫术消融术式:双侧肺静脉隔离、左房顶部线、二尖瓣、三尖瓣峡部线消融,随访近两年来在本中心仿外科迷宫消融术的51例LS-AF患者,LS-AF持续时间:(67.9±66.5)个月。结果 51例LS-AF患者术后即刻成功率96%(49/51),随访时间(21.2±5.4)个月,成功率75%。除消融术后即刻未维持窦性心律2例,其余49例术后左房直径明显缩小,射血分数明显升高[(34.8±6.0)ms vs(41.6±6.4)mm,0.58±0.04 vs 0.48±0.04,P均<0.05]。结论仿外科迷宫消融术治疗LS-AF术后即刻成功率较高,中短期随访成功率高。消融术后明显改善患者心功能、心房重构。

Objective To observe the effects of long-term persistent atrial fibrillation （LS-AF） ablation using imitation the surgery maze procedure ablation strategy. Method Imitated the surgery maze procedure ablation：pulmonary veins isolation, left atrial roof line, mitral valve and tricuspid isthmus line bidirectional conduction block. Fifty-one patients with drug-refractory LS-AF underwent radiofrequency catheter imitation the surgery maze procedure ablation. Mitral valve, three tricuspid isthmus bidirectional conduction block. Octorber 2010 to August 2011 were enrolled. Mid-term follow-up of （21.2±5.4） months average （ range 13 to 34 months） was performed in the 51 patients. Results After the first ablation procedure, 10 of 51 （ 19.6% ） patients restored sinus rhythm, After multiple procedures, 49 of 51 （96%） patients restored sinus rhythm. Follow up （21.2±5.4） months, sinus rhythm was maintained in 38 of 51 （75%） patients. After ablation, LA diameter significantly reduced（ P〈0. 05 ）and ejection fraction increased significantly（ P〈0.05 ） than pre-ablation in those 49 patients with 96% success rate of ablation. Conclusion The success immediately rate and the mid-term follow up success rate of modification of the maze procedure ablation are very high, atrial remodelling and heart function also improve obviously after ablation.