高功率房颤消融对术中急性肺静脉隔离及术后肌钙蛋白水平的影响

The effect of high-power atrial fibrillation ablation on intraoperative acute pulmonary vein isolation and postoperative troponin levels

目的研究对比高功率与常规功率房颤消融对术中急性肺静脉隔离、术后肌钙蛋白水平及房颤复发的影响。方法回顾性选取2017年1月至2020年12月保定市第一中心医院收治的阵发性房颤患者105例,按治疗方法不同分为高功率消融组(52例)及常规功率消融组(53例),对比两组术中单圈急性肺静脉隔离率、急性肺静脉隔离后电传导恢复情况、需补点的部位及点数;同时对比两组手术时间、消融时间、手术射线曝光时间及射线量,术中并发症,术后12 h肌钙蛋白水平、消融术后1年内房颤复发情况。结果高功率房颤消融组的术中单圈肺静脉隔离率、术后肌钙蛋白水平高于常规房颤消融组(均P<0.05),手术时间、消融时间、术中需补点的部位及点数少于常规房颤消融组(均P<0.05)。两组术中并发症及术后房颤复发率比较差异无统计学意义(均P>0.05)。结论高功率房颤消融对比常规消融有更高的单圈急性肺静脉隔离率、更少补点部位及点数、较短的手术时间、更大消融损伤,且两组术后临床疗效相似。

Objective To compare the effects of high-power and conventional power atrial fibrillation ablation on intraoperative acute pulmonary vein isolation,postoperative troponin levels,and atrial fibrillation recurrence.Methods A retrospective selection was conducted on 105 patients with paroxysmal atrial fibrillation admitted to the Baoding NO.1 Central Hospital from January 2017 to December 2020.According to different treatment methods,they were divided into a high-power ablation group of 52 cases and a conventional power ablation group of 53 cases.The intraoperative rate of single circle acute pulmonary vein isolation,the recovery of electrical conduction after acute pulmonary vein isolation,and the location and number of points that need to be added were compared between the two groups;At the same time,two groups were compared in terms of surgical time,ablation time,surgical radiation exposure time and radiation dose,intraoperative complications postoperative cardiac troponin levels at 12 hours,and recurrence of atrial fibrillation within 1 year after ablation.Results The intraoperative single loop pulmonary vein isolation rate and postoperative troponin levels in the high-power atrial fibrillation ablation group were higher than those in the conventional atrial fibrillation ablation group(all P<0.05).The surgical time,ablation time,and the number of sites and points that need to be added during surgery were less than those in the conventional atrial fibrillation ablation group(all P<0.05).There was no statistically significant difference in the incidence of intraoperative complications and postoperative atrial fibrillation recurrence between the two groups(all P>0.05).Conclusions High power atrial fibrillation ablation has a higher single loop acute pulmonary vein isolation rate,fewer patch sites and points,shorter surgical time,and greater ablation damage compared to conventional ablation,and the clinical efficacy of the two groups is similar after surgery.