远程心电监测系统在心房颤动患者导管消融与抗心律失常药物治疗中的随访应用

A compare of catheter ablation and antiarrhythmic drugs for patients with atrial fibrillation using tran- stelephonic monitor system

目的采用远程心电监测系统（transtelephonic monitorsystem，1TM）进行随访比较心房颤动（房颤）患者导管消融治疗与抗心律失常药物（antiarrhythmic drugs，AAD）的治疗效果。方法从2012年6月到2014年2月，在武汉大学人民医院心血管内科接受治疗的房颤患者162例，其中男92例，女70例。分为导管消融组与AAD组，并使用TTM进行随访，采用Kaplan—Meier方法分析房颤复发因随访时间进程而变化的情况。结果共人选162例房颤患者，随访期间使用TFM共收集到20946份有效心电图，9824份异常心电图中无症状发作的3229份（32．9％），8800份窦性心电图中有症状的2598份（29．5％）。阵发性房颤患者（82例）中，消融组房颤随时间复发率低于AAD组（P=0．011）；在持续性房颤患者（80例）中，消融组房颤随时间复发率低于AAD组（P=0．006）。结论通过短期随访发现，对于房颤患者的窦性心律维持，导管消融要优于AAD。TTM可有效提高房颤复发检出率，可用于评估导管消融治疗房颤的临床有效性。

Objective To compare the effectiveness of catheter ablation and antiarrhythmic drugs （AAD）for patients with atrial fibrillation（AF）. Methods Patients with AF in our hospital were enrolled in this research and were distributed into catheter ablation group and AAD group. Follow-ups were carried out with the usage of transtelephonic monitor system（TTM） and Kaplan-Meier method was used to analyze the relapse of AF with time. Results One hundred and sixty-two patients were enrolled in the research. During follow-up, 20 946 electrocardiograms （ECG）were recorded by TTM totally.Among 9 824 abnormal ECG, 3 229 ECG were silent with- out any symptoms （ 32.9% ）.Among 8 800 sinus ECG, 2 598 （ 29.5% ） cases had symptoms. In paroxysmal AF pa- tients ,the rate of relapse of AF in catheter ablation group was lower than that in AAD group（P=0.011 ）.In persis- tent AF patients, the rate of relapse of AF in catheter ablation group was lower than that in AAD group （P = 0. 006） ,as well. Conclusion In a short-term of follow-up,catheter ablation is superior to AAD in AF patients in maintaining sinus rhythm.T＇FM can improve the detection rate of AF relapse effectively and can be used as an evaluation tool of the catheter ablation.