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阵发性心房颤动射频导管消融术后生活质量随访 被引量:14

Quality of life in patients with paroxysmal atrial fibrillation after pulmonary vein isolation by radiofrequency catheter ablation
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摘要 目的 探讨经导管射频消融治疗阵发性心房颤动 (房颤 )的安全性、有效性以及对生活质量的影响。方法  30例药物难治性阵发性房颤 ,在环状电极导管 (Lasso导管 )指导标测下行肺静脉或上腔静脉电隔离 ,术后随访并行隔离术前后生活质量调查。结果 有 2 9例达消融终点 ,随访 1~ 2 6个月 ,17例消融成功 ,无需药物可以维持窦性心律 ,加用以前无效的抗心律失常药物后 ,有 2 2例无房颤复发。生活质量(QOL)调查示隔离术前后相比 ,SF 36量表中除肌体疼痛差异无显著性外 ,其它 7项指标 :躯体功能、躯体角色、总的健康状况、活力、社会功能、情感角色和心理健康 ,术后均有改善 (P <0 0 5 ) ;而症状列表中除胸痛外 ,心悸、心动过速、呼吸困难、头昏、活动受限 ,术后均有改善 (P <0 0 5 )。结论 部分药物难治性房颤患者可行射频导管消融肺静脉电隔离治疗 ,成功地消除房颤可明显提高患者的QOL且改善症状。 Objective To investigate the efficacy,safety and effects on quality-of-life(QOL)of pulmonary vein isolation by radiofrequency catheter ablation in patients with paroxysmal atrial fibrillation(AF).Methods Guided by Lasso mapping catheter,electrical isolation of the pulmonary veins or superior vena cava were performed on thirty drug refractory AF patients.QOL was measured with the SF-36 and symptom checklist survey before and after the procedure.Results Twenty-nine patients achieved the procedural endpoint.After a mean follow-up of 1~26(7.7±6.2)months,17 patients were free from AF without antiarrhythmic drug,5 patients were recurrence-free taking previously ineffective drug.There was a significant improvement in QOL after a successful catheter ablation(except for body pain).There was also a significant change in clinical symptoms(except for chest pain).Conclusions Pulmonary vein isolation by radiofrequency catheter ablation is safe for the treatment of drug refractory paroxysmal AF patients,and there is a significant improvement in QOL and symptoms after the successful procedure.
出处 《中华心律失常学杂志》 2004年第4期215-218,共4页 Chinese Journal of Cardiac Arrhythmias
关键词 生活质量 术后 阵发性心房颤动 随访 QOL 难治性 术前 药物 患者 射频导管消融术 Atrial fibrillation Radiofrequency catheter ablation Quality of life
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  • 1Tsai CF, Chen SA, Tai CT, et al. Bezold-Jarisch-like reflex during radiofrequency ablation of the pulmonary vein tissues in patients with paroxysmal focal atrial fibrillation. J Cardiovasc Electrophysiol, 1999, 10: 27.
  • 2Fitzpatrick AP, Kourouyan HD, Siu A, et al. Quality of life and outcomes after radiofrequency His-bundle catheter ablation and permanent pacemaker implantation: impact of treatment in paroxysmal and established atrial fibrillation.Am Heart J, 1996, 131: 4
  • 3Haissaguerre M, Jais P, Shah DC, et al. Electrophysiological end piont for catheter ablation of atrial fibrillation initiated from multiple pulmonary venous foci. Circulation,2000, 101: 1409-1417.
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  • 5Luderitz B, Jung W. Quality of life in patients with atrial fibrillation. Arch Intern Med, 2000, 160: 1749-1757.
  • 6Ware JE Jr, Sherbourne CD. The MOS 36-item short-form health survey( SF-36): Ⅰ. Conceptual framework and item selection. Med Care, 1992, 30: 473-483.

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