药物及导管消融治疗肥厚型心肌病合并心房颤动患者疗效及安全性对比研究

Comparative study on efficacy and safety of drugs and catheter ablation in patients with hypertrophic cardiomyopathy and atrial fibrillation

目的:研究药物及导管消融对肥厚型心肌病合并心房颤动患者的疗效及安全性。方法:选取我院收治的肥厚型心肌病合并心房颤动患者164例,分为导管消融组(n=82)和药物治疗组(n=82),比较2组的疗效及安全性。结果:导管消融组成功完成房颤导管消融术,术后平均随访时间为(17.9±7.8)个月,28例出现房颤复发情况,16例进行2次导管消融治疗。药物治疗组平均随访时间为(10.9±8.1)个月,29例转复为窦性心律。导管消融组的窦性心律维持率显著高于药物治疗组(P<0.01)。随访结束时,导管消融组地高辛及β受体阻滞药使用率明显低于药物治疗组(P<0.01);导管消融组非二氢吡啶类钙离子拮抗药、胺碘酮、索他洛尔使用率低于药物治疗组,但差异不显著。导管消融组5例为计划性住院;4例为非计划性住院,均为快速心律失常。药物治疗组4例为计划性住院;19例为非计划性住院,其中6例为快速心律失常,1例为窦性心动过缓,3例为出血,1例为卒中,8例为心力衰竭。结论:肥厚型心肌病合并心房颤动患者行导管消融治疗效果优于药物治疗,安全性也更高。

Objective：To study the efficacy and safety of the drug and catheter ablation in patients with hypertrophic cardiomyopathy complicated with atrial fibrillation.Methods：A total of 164 cases of hypertrophic cardiomyopathy complicated with atrial fibrillation patients in our hospital were selected and divided into the catheter ablation group（n=82）,and the drug group（n=82）,the efficacy and safety of the two groups were compared.Results：Catheter ablation group had successful catheter ablation of atrial fibrillation surgery,the average follow-up time was（17.9±7.8）months,28 cases of recurrent atrial fibrillation,16 cases of catheter ablation second time.The mean follow-up time in the drug group was（10.9±8.1）months,29 patients were converted to sinus rhythm.Rhythm maintenance rate in catheter ablation group was significantly higher than that in the drug group.At the end of the follow-up,the usage rates of digoxin and beta receptor blockers in catheter ablation group were significantly lower than that in drug group,the usage rates of two non hydrogen pyridine calcium antagonists,amiodarone,sotalol in catheter ablation group were lower than those in the drug group,but the difference was not significant.Five cases of hospitalization plan catheter ablation group,4cases of unplanned hospitalization,including 4cases of arrhythmia hospitalization;4cases treated with drugs for planning in hospital,19 cases of unplanned hospitalization,including 6cases of rapid arrhythmia,1 cases of sinus bradycardia,3 cases of hemorrhage,1cases of stroke inpatients,8patients hospitalized for heart failure.Conclusion：Catheter ablation treatment is better than drug therapy in patients with hypertrophic cardiomyopathy complicated with atrial fibrillation,catheter ablation has higher security.