持续性心房颤动射频消融术后发生心动过缓的原因分析

Analysis of the causes of bradycardia in patients with persistent atrial fibrillation after radio frequency ablation

目的探究持续性心房颤动患者行射频消融术后出现显著心动过缓的原因及应对策略。方法将我院76例持续性房颤的患者射频消融治疗的临床资料进行回顾性分析。结果76例持续性房颤患者,射频消融术后出现3例严重的窦性心动过缓,伴窦性停搏及交界性逸搏,最长窦性停搏时间为9秒。观察1周症状无改善后有2例植入双腔永久起搏器;1例有所改善,但仍有窦性停搏及逸搏,因窦性停搏时间<3秒,无明显头昏、晕厥等症状拒绝安装起搏器。结论持续性房颤消融术后出现的严重心动过缓原因复杂,但主要是在未出现房颤之前就已经存在病态窦房结综合征的可能性最大,永久起搏器植入是首选。

Objective To explore the reasons and countermeasures of causes of bradycardia in patients with persistent atrial fibrillation after radio frequency ablation.Methods A total of retrospective analysis of 76 cases in our hospital of bradycardia in patients with persistent atrial fibrillation after radio frequency ablation.Results 3 cases resulted in serious sinus bradycardia,sinus arrest,and junctional escape rhythm,in which the longest time of sinus arrest is 9 seconds.in 76 cases with persistent atrial fibrillation after radio frequency ablation,After observing for one week,the clinical effect had non-improvement,2 patients accepted Two-chamber permanent pacemaker-implantation and one’s symptoms improved,but still had sinus arrest,and junctional escape rhythm,with the sinus arrest time less than 3 seconds,No obvious symptoms of dizziness or syncope comes out so that this patient refuse to accect the implantation of Two-chamber permanent pacemaker.Conclusion There are complex reasons for causes of bradycardia in patients with persistent atrial fibrillation after radio frequency ablation,However,the possibility of sick sinus node syndrome is most likely before atrial fibrillation,and permanent pacemaker implantation is the first choice.