不同射频消融策略治疗长期持续性心房颤动的临床价值比较

Clinical values of different strategies of radiofrequency ablation in treatment of long-term sustained atrial fibrillation

目的分析不同射频消融策略治疗长期持续性心房颤动的临床价值。方法选择在武警总医院住院治疗的长期持续性心房颤动患者作为研究对象,随机分为接受环肺静脉前庭消融(CPVA)和左房线性消融后再电复律的对照组、接受CPVA后即电复律再行左房线性消融的观察组,比较两组患者的手术相关指标、心功能及血清高敏C反应蛋白(hs-CRP)水平等差异。结果观察组患者接受治疗后的手术总时间、线性消融时间、消融放电时间及X线曝光时间均明显少于对照组患者(P<0.05);观察组患者接受治疗后的左心房内径(LAD)值低于对照组、左室射血分数(LVEF)水平高于对照组(P<0.05);观察组患者接受治疗后各个时期的血清hs-CRP水平明显低于对照组患者(P<0.05)。结论 CPVA后即电复律再行左房线性消融不仅手术过程更为合理,可以更大程度的增强持续性心房颤动患者心功能、降低血清hs-CRP水平。

Objective To analyze the clinical values of different strategies of radiofrequency ablation（RFA） in treatment of long-term sustained atrial fibrillation（AF）. Methods The patients with long-term sustained AF hospitalized in the General Hospital of Chinese People＇s Armed Police were chosen and randomly divided into control group [treated with electrical cardiovension after circumferential pulmonary vein ablation（CPVA） and left atrial linear ablation] and observation group（treated with electrical cardiovension immediately after CPVA and then given left atrial linear ablation）. The indexes related to the operation, heart function and level of serum high-sensitivity C-reactive protein（hs-CRP） were compared between 2 groups. Results The total duration of the operation, and durations of left atrial linear ablation, ablation discharge and X-ray exposure were significantly less in observation group than those in control group after treatment（P〈0.05）. The index of left atrial diameter（LAD） was lower and index of left ventricular ejection fraction（LVEF） was higher in observation group than those in control group after treatment（P〈0.05）. The level of hs-CRP was significantly lower in observation group than that in control group at each stage after treatment（P〈0.05）. Conclusion The therapy of electrical cardiovension immediately after CPVA and then left atrial linear ablation is more reasonable, and can improve heart function and reduce the level of hs-CRP in patients with long-term sustained AF.