ATP联合异丙肾上腺素在环肺静脉消融术中的应用价值

Application value of ATP combined with isoprenaline in circumferential pulmonary vein ablation

目的 探讨三磷酸腺苷（ATP）联合异丙肾上腺素在环肺静脉消融术中的应用价值。方法 分别将30例与23例阵发性心房颤动（房颤）患者作为本研究的试验组与对照组,对照组单行环肺静脉消融术进行治疗,试验组在对照组基础上加用ATP与异丙肾上腺素的联合治疗。观察两组疗效。结果 121根隔离肺静脉中有27根（22.3%）出现肺静脉电位恢复,这些病例均再次隔离后重新开始试验,ATP诱发肺静脉电位传导恢复发生在11例患者中,占总例数的36.7%;随访1~2年,试验组仅有5例（16.7%）患者出现中远期复发,而对照组共有7例（30.4%）患者出现远期复发,组间比较房颤的远期复发率试验组更低,差异有统计学意义（χ^2=5.147,P〈0.05）。结论 ATP联合异丙肾上腺素在环肺静脉消融术中具有重要应用价值,值得心血管临床给予其更高程度的关注。

Objective To explore the application value of adenosine triphosphate（ATP） combined with isoprenaline in circumferential pulmonary vein ablation. Methods There were 30 cases and 23 cases of paroxysmal atrial fibrillation as experimental group and control group of this study. The control group received circumferential pulmonary vein ablation alone for treatment, while the experimental group received additional combination treatment by ATP and isoprenaline. Curative effects of the two groups were observed. Results Among 121 isolated pulmonary veins, there were 27（22.3%） of them with pulmonary vein electrical recovery, and they all received isolation again for reexamination. There were 11 cases with recovered pulmonary vein electrical conduction induced by ATP, which accounted for 36.7%. After 1~2 years of follow-up, there were 5 cases（16.7%） of mid-long-term recurrence in the experimental group, and 7 cases（30.4%） of mid-long-term recurrence in the control group. The experimental group had much lower long-term recurrence rate of atrial fibrillation than the control group, and the difference between the two groups had statistical significance（χ^2=5.147, P〈0.05）. Conclusion The combination of ATP and isoprenaline has important application value in circumferential pulmonary vein ablation, and it is worthy of high attention by cardiovascular clinic.