肺静脉开口面积与持续性心房颤动射频消融术后复发的关系

The relationship between pulmonary vein′s openning area and the recurrence of persistent atrial fibrillation after radiofrequency catheter ablation.

目的探讨各肺静脉开口面积对持续性心房颤动(简称房颤)患者导管射频消融(RFCA)术后复发的相关性。方法回顾性分析于郑州大学第一附属医院首次且成功行RFCA手术的持续性房颤患者64例,所有患者术前均行左房64排CT血管造影成像检查测定左上肺静脉、左下肺静脉、右上肺静脉、右下肺静脉、左心房容积(LAV)及左心房前后径(LAAPD)。采取CARTO三维标测系统指导下房颤RFCA术。所有患者均于术后1、3、6、9、12个月复查动态心电图,对于术后未见门诊动态心电图复查的给予电话随访,询问房颤是否复发。根据房颤是否复发,将患者分为复发组和未复发组,比较两组患者的一般资料、各肺静脉开口面积、LAV、LAAPD的差异性。结果复发组(26例)与非复发组(38例)相比,复发组RSPV开口面积明显增大[(336.68±132.74)mm^3 vs (256.12±96.46)mm^3;P<0.01],房颤病程较长[(46.50±24.43)个月vs (33.63±11.96)个月;P<0.05]。结论持续性房颤RFCA术后复发与RSPV开口面积及房颤病程长短相关。

Objective To investigate the correlation between the area of pulmonary vein opening area and the recurrence of persistent atrial fibrillation(AF) after radiofrequency catheter ablation(RFCA). Methods Sixty-four patients with persistent AF who underwent radiofrequency catheter ablation successfully for the first time in the first affiliated Hospital of Zhengzhou University were analyzed retrospectively. All patients underwent left atrial CTA examination before operation to determine left superior pulmonary vein, left inferior pulmonary vein,Right superior pulmonary vein(RSPV), right inferior pulmonary vein(RIPV), left atrial volume(LAV) and left atrial anteroposterior diameter(LAAPD). Radiofrequency ablation of AF was guided by CARTO three-dimensional mapping system. All patients were examined with dynamic electrocardiogram(ECG) at 1,3,6,9 and 12 months after RFCA. For those who did not see ambulatory electrocardiogram after operation, they were followed up by telephone and asked if there was any recurrence of AF. According to whether the AF recurred, the patients were divided into recurrent group and no recurrence group,and then we compared the difference of pulmonary vein opening area,the general data,the area of pulmonary vein opening and LAV,LAAPD between the two groups. Results The open area of RSPV was significantly increased in recurrent group(n=26) than that in no recurrence group[(336.68±132.74)mm^3 vs(256.12±96.46)mm^3;P<0.01]. The course of AF was longer in recurrent group(n=38) than that in no recurrence[(46.50±24.43)months vs(33.63±11.96) months;P<0.05]. Conclusion Recurrence after RFCA of persistent AF is related to the RSPV opening area and the duration of AF.