心房颤动患者经导管射频消融术后的疗效观察

Therapeutic effect of radiofrequency ablation in patients with atrial fibrillation

目的通过对行导管射频消融术后的心房颤动患者进行随访及资料分析,评估房颤导管射频消融术的疗效与安全性。方法回顾性分析自2008年3月~2013年1月在西安交通大学医学部第一附属医院接受经射频消融治疗的47例心房颤动患者的临床资料,术后定期随访,复查24h动态心电图（Holter）,观察心律失常发作情况,复查心动超声,了解左房内径大小,平均随访32月。结果房颤消融术即刻成功率为82.6%;房颤消融治疗成功率为65.0%,阵发性房颤消融治疗成功率为69.7%,持续性/长时间持续性房颤消融治疗成功率为42.9%;经消融术后左房直径[（36.3±4.3）mm]较术前[（38.1±5.9）mm]明显缩小（P〈0.001）;房颤复发患者的年龄较未复发者稍大,复发者的左心房内径与未复发者大,且其高血压患病率高于未复发者（P〈0.05）;消融术后患者房颤负荷均值为14.9%,较术前房颤负荷均值46.1%明显减小（P〈0.05）。结论导管射频消融术治疗房颤是安全有效的,特别是对阵发性房颤疗效明显;房颤导管射频消融术可显著缩小左心房内径。

Objective To assess the therapeutic effect and safety of radiofrequency catheter ablation of atrial fibrillation.Methods We analyzed the clinical data of 47 patients with atrial fibrillation who underwent radiofrequency catheter ablation between March 2013 and January 2008,in the First Affiliated Hospital of Xi＇an Jiaotong University.In the average 32 months＇follow-up,Holter monitering and echocardiography were reviewed for the left atrial diameter.Results The immediate success rate of catheter ablation for atrial fibrillation was82.6%.The long-term success rate was 65%,the rate of paroxysmal atrial fibrillation was 69.7%,and the rate of longstanding persistent atrial fibrillation was 42.9%.After ablation,the left atrial diameter were markedly reduced compared with that before treatment[（36.3±4.3）mm vs.（38.1±5.9）mm）（P〈0.001）.The patients with recurrent atrial fibrillation were older than those without recurrence,their left atrial diameter was bigger,and the prevalence rate of hypertension was higher（P〈0.05）.The average atrial fibrillation load was 14.9% after ablation compared with46.1% before（P〈0.05）.Conclusion Radiofrequency catheter ablation is an effective and safe treatment of atrial fibrillation,especially for paroxysmal atrial fibrillation.The left atrial diameter was significantly decreased after radiofrequency catheter ablation compared with that before the ablation.