持续房颤射频消融128例临床观察

Clinical Observation of 128 Cases of Sustained Atrial Fibrillation Radiofrequency Ablation

目的探讨持续房颤射频消融治疗临床效果。方法本次选取128例持续房颤患者,均为我院2012年5月～2014年2月收治,采用射频消融治疗。结果相较术前,患者术后均觉心悸症状持续时间及发作次数明显改善。术后1 d有阵发性房颤发作5例,行1年随访,房颤持续明显减少,经二次射频消融治疗治愈。术后有频发房速15例,口服抗心律失常药,随访2个月,房早（155±71）个,12个月时为（54±16）个,自觉症状明显改善。手术中有心包填塞出现1例,采用外科手术治疗,达治愈效果。结论针对持续性房颤,在CARTO三维立体电标测指导下,实施环肺静脉消融治疗,可获得理想预后,为治愈提供有力的保障。

Objective To explore the clinical therapeutic effect of persistent atrial fibrillation radiofrequency ablation.Methods 128 cases of persistent atrial fibrillation patients were selected,who were admitted in our hospital from May 2012 to February 2014,were treated with radiofrequency ablation.Results In comparison with pre-operation,all the patients felt that the palpitation duration and the onset frequency were obviously improved.There were 5 cases with onset of paroxysmal atrial fibrillation one day after operation,the duration of atrial fibrillation was significantly reduced after one year follow-up visit,and the atrial fibrillation was cured by second radiofrequency ablation.There were 15 cases of frequent postoperative atrial tachycardia,they were treated with oral Antiarrhythmic agent,there were（155±71） cases of atrial premature beat after 2 months follow-up visit,and（54±16） cases of atrial premature beat after 12 months follow-up visit,the patients felt that the symptoms improved significantly.There was one case with pericardial tamponade during the Surgery,and it was treated with surgical treatment,the curative effect was achieved.Conclusion Under three-dimensional electric CARTO mapping guidance,the implementation of circumferential pulmonary vein ablation for persistent atrial fibrillation patients can achieve ideal prognosis and can also provide strengthful security for the cure of the disease.