VisiTag指导下的量化消融与压力导管指引下的拖动消融治疗阵发性心房颤动的效果比较

Comparison of efficacy for patients with paroxysmal atrial fibrillation by visitag-guided quantitative ablation versus pressure catheter-guided drag ablation

目的比较VisiTag指导下的量化消融与压力导管指引下的拖动消融治疗阵发性心房颤动(PAF)的临床效果。方法回顾性选取2020年3月至2023年10月浙江省医疗健康集团衢州医院收治的行射频消融手术治疗的PAF患者78例。其中39例患者采用VisiTag指导下的量化消融治疗,为观察组;另39例患者采用压力导管指引下的拖动消融治疗,为对照组。观察并比较两组患者手术指标、手术前后血清可溶性基质裂解素2(sST2)与半乳糖凝集素3(gal-3)水平、心脏功能、并发症发生情况及复发情况。结果观察组患者接触压力高于对照组,手术时间、射频消融时间、X线曝光时间均短于对照组,消融点数目少于对照组,差异均有统计学意义(均P<0.05)。术后6个月,两组患者血清sST2、gal-3水平均较术前降低(均P<0.05),且观察组低于对照组(均P<0.05)。与术前比较,两组患者术后3~6个月左心房内径均缩小(均P<0.05),且观察组小于对照组(均P<0.05);两组的左心室射血分数均升高(均P<0.05),且观察组高于对照组(均P<0.05)。观察组患者并发症发生率和术后3、6个月复发率均低于对照组(38.46%比61.54%、5.13%比20.51%、12.82%比35.90%,均P<0.05)。结论与压力导管指引下的拖动消融相比,Visitag指导下的量化消融可改善PAF患者手术指标,降低血清sST2、gal-3水平,提高心脏功能,降低并发症发生率和复发率,值得临床推广应用。

Objective To compare the clinical outcomes of VisiTag-guided quantitative ablation with pressure catheter-guided drag ablation for patients with paroxysmal atrial fibrillation(PAF).Methods Seventy-eight patients with PAF who underwent radiofrequency ablation in Quzhou Hospital of Zhejiang Medical and Healthcare Group from March 2020 to October 2023 were included in the study.Among them,39 patients were treated with VisiTag-guided quantitative ablation(study group)and 39 patients were treated with pressure catheter-guided drag ablation(control group).The surgical indexes,serum soluble stromal cleavage 2(sST2)and galactose lectin 3(gal 3)levels before and after surgery,cardiac function,occurrence of complications,and recurrence were compared between two groups.Results The contact pressure of the study group was higher than that of the control group;the operation time,radiofrequency ablation time,X-ray exposure time were shorter than those of the control group;and the number of ablation points was less than that of the control group(all P<0.05).At 6 months postoperatively,serum sST2 and gal 3 levels were lower in both groups compared with preoperative levels(both P<0.05);while the above indicators were lower in the observation group than those in the control group(both P<0.05).The left atrial internal diameter was lower at 3 to 6 months after ablation than that before operation in both groups(both P<0.05),while the diameter in study group was lower than that in the control group(both P<0.05).The left ventricular ejection fraction(LVEF)of the two groups were elevated after ablation(both P<0.05),while the LVEF in the study group was higher than that in the control group(both P<0.05).The complication rate and the recurrence rate at 3 months postoperatively and 6 months postoperatively in the study group were lower than those in the control group(38.46%vs.61.54%,5.13%vs.20.51%,and 12.82%vs.35.90%,all P<0.05).Conclusion Compared with pressure catheter-guided drag ablation,Visitag-guided quantitative ablation has better surgical indexes,better postoperative cardiac function,lower postoperative serum sST2 and Gal 3 levels,lower complication rate and recurrence rate for PAF patients,which is worthy of clinical promotion and application.