摘要
目的 研究持续性心房颤动（房颤）导管射频消融最佳手术方式及复发心律失常的处理策略。方法 2005年3月～2007年8月共40例持续性房颤患者接受导管射频消融治疗，三维电解剖标测系统指导下行环同侧肺静脉左心房线性消融；2005年的12例患者部分附加左心房峡部、右心房峡部、左心房顶部线性消融；2006年的12例患者常规进行左心房峡部、右心房峡部射频消融，部分患者附加碎裂电位、左心耳或根据术中的房性心律失常附加其他部位射频消融；2007年的16例患者则在上述基础上进行冠状窦左心房心内膜面射频消融。结果 2005年复发8例（66．7％），2006年复发3例（25．0％），2007年复发4例（25．0％）。复发的患者中8例接受第二次导管射频消融术，其中5例维持窦性心律。平均随访（17．6±10．4）个月，总治疗成功率82．5％。结论 持续性房颤患者在以肺静脉口为核心的导管射频消融前提下，适当改进导管射频消融策略，可以显著提高成功率。
Objective To study the optimal catheter ablation strategy for persistent atrial fibrillation（AF） and the strategy for management of recurrent atrial tachyarrhythmia. Methods Forty consecutive patients with persistent AF undergoing catheter ablation therapy from March 2005 to August 2007 were analysed, including 12 patients in 2005, 12 patients in 2006 and 16 patients in 2007. The procedures were guided by CARTO mapping system and circle catheter and all patients underwent circumferential pulmonary-vein ablation（CPVA）. Linear ablation along mitral isthmus and cavotricuspid isthmus was performed routinely in patients in 2006 and 2007, but only in a part of patients in 2005 according to their atrial arrhythmia before or during the procedure. Linear ablation along atrial side of coronary sinus was performed in 2007. When AF remained, ablation targeting complex fractional atrial electrograms（CFAE）, roof line or left atrial appendage was performed in 2006 and 2007. Results Eight patients with recurrent AF or atrial tachycardia underwent second ablation and 5 of them succeeded. The patients were followed up for （17. 6±10.4） months. The total success rate was 82.5%. Conclusions Linear lesions and CFAE ablation in addition to CPVA in patients with persistent AF significantly improved rate of sinus rhythm.
出处
《中华老年心脑血管病杂志》
CAS
北大核心
2008年第8期563-565,共3页
Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
基金
广东省医学科研基金(A2006043)
关键词
心房颤动
导管消融术
心律失常
复发
肺静脉
atrial fibrillation
catheter ablation
arrhythmia
recurrence
pulmonary veins
