室性早搏射频消融术后使用盐酸胺碘酮时间对治疗成功率的影响

Effect of amiodarone hydrochloride treatment time on treatment success rate of ventricular premature beats after radiofrequency ablation

目的 探讨室性早搏射频消融术后使用盐酸胺碘酮时间对成功率的影响。方法 选取2013年2月~2015年2月温州医科大学附属黄岩医院心内科初次接受RFCA的频发室性早搏患者46例,随机分为2组,术后对照组口服盐酸胺碘酮1个月,研究组口服盐酸胺碘酮6个月。检测左心功能和结构参数、心率变异系数,比较2组主要临床症状评分、成功率、疗效及安全性。结果 与治疗1个月比较,2组LVESD、LVEDD和PVC降低（P〈0.05）,LVEF升高（P〈0.05）,SDNN、r MSSD、PNN50、LF、HF升高（P〈0.05）,心悸、胸闷及气短主要症状评分降低（P〈0.05）;与对照组比较,研究组PVC较低（P〈0.05）,LVEF较高（P〈0.05）,LVESD、LVEDD无差异,SDNN、r MSSD、PNN50、LF、HF较高（P〈0.05）,心悸、胸闷以及气短主要症状评分较低（P〈0.05）,2组RFCA术后成功率、临床疗效及不良反应发生率均无显著差异。结论 PVCs患者射频消融术后服用胺碘酮时间对治疗成功率无影响,但服药6个月与服药1个月相比,能减轻心悸、胸闷等症状,并改善左心室功能,且安全性高。

Objective To investigate the effect of treatment time with amiodarone hydrochloride on treatment success rate o f ventricular premature beats after radiofrequency ablation. Methods 46 cases o f patients with frequent premature ventricular arrhythmia who received RFCA for the first time in department of gardiology,huangyan hospital of wenzhou medical university from February 2013 to February 2015 were selected,and randomly divided into two groups,the control group were treated with amiodarone hydrochloride for one months,the study group were treated with amiodarone hydrochloride for six months.Lefl ventricular function and structural parameters,heart rate variability were measured in two groups,the main clinical symptom scores,success rate,efficacy and safety were compared. Results Compared with before treatment,two groups o f LVESD,LVEDD and PVC decreased （P〈0.05）,LVEF increased （P〈0.05）,SDNN,rMSSD,PNN50,LF and HF increased （P〈0.05）,scores of palpitation,shortness of breath,chest tightness and main symptom score decreased （P〈0.05）.Compared with the control group,level of PVC in the study group was lower （P〈0.05）,LVEF was higher（尸〈0.05） ,LVESD and LVEDD were had no significant differences,levels of SDNN, rMSSD, PNN50, LF,HF were higher （尸〈 0 .0 5 ） ,scores of palpitations,shortness of breath,chest tightness main symptom score were lower （P〈0.05）.There were no significant differences in the success rate, clinical efficacy and adverse reaction rate between the two groups. Conclusion The time o f taking amiodarone after radiofrequency catheter ablation in patients with PVCs,but taking six months and medication compared to one month,can reduce heart palpitations,chest tightness and other symptoms,and improve left ventricular function,with high security.