射频消融节律控制治疗心力衰竭合并心房颤动的疗效观察

Observation on the Curative Effect of Radiofrequency Ablation Rhythm Control in the Treatment of Heart Failure Complicated with Atrial Fibrillation

目的:观察射频消融节律控制治疗心力衰竭(简称心衰)合并心房颤动(简称房颤)的临床疗效。方法:随机双盲法将70例心衰合并房颤患者分为两组各35例,对照组采取药物室率控制、抗凝治疗,观察组则行射频消融节律控制治疗,比较两组临床疗效、治疗前后心功能变化及不良心脑血管事件发生率。结果:观察组总有效率91.4%,显著高于对照组的71.4%,P<0.05。两组治疗后LVEF[(51.4±13.4)VS(44.2±15.8)]%、LAD[(38.7±7.9)VS(57.0±10.2)]mm比较,差异显著(P<0.05)。随访6个月,观察组脑梗死发生率、房颤复发率分别为0.0%、8.6%,显著低于对照组的17.1%、37.1%(P<0.05)。结论:射频消融节律控制治疗心衰合并房颤效果明显优于室率控制方案,能明显改善患者心功能,降低不良心脑血管事件发生率。

Objective： To observe the clinical curative effect of radiofrequency ablation rhythm control in thetreatment of heart failure （HF） complicated with atrial fibrillation （AF）.Methods：70 patients with heart failure complicatedwith atrial fibrillation were divided into 2 groups by random double blind method with 35 cases in each group. The controlgroup to were treated by drug ventricular rate control and anticoagulant therapy while the observation group were treatedby radiofrequency ablation rhythm control. The clinical effects, changes of cardiac function before and after the tretmentand the incidence of adverse cardiovascular and cerebrovascular events were compared between the 2 groups. Results：Thetotal effective rate in the observation group （91.4%） was significantly higher than that in the control group （71.4%）,P〈0.05.After the treatment, the differences in LVEF[（51.4±13.4） VS （44.2±15.8）]% and LAD[（38.7±7.9）VS（57.0±10.2）]mmbetween the two group were significant （P〈0.05）. In 6 months of follow-up, the incidence rates of cerebral infarction andthe recurrence rate of atrial fibrillation in the observation group （0.0%, 8.6%） were significantly lower than those in thecontrol group （17.1%,37.1%）,P〈0.05.Conclusion：The effect of radiofrequency ablation rhythm control in the treatment ofheart failure complicated with atrial fibrillation is significantly better than that of ventricular rate control. It can improvethe cardiac function and reduce the incidence of adverse cardiovascular and cerebrovascular events.