摘要
目的探讨肺静脉结构特点及左心房内径（LAD）与心房颤动（房颤）经导管射频消融术后复发的相关性。方法收集267例经导管射频消融房颤患者的术前资料，通过经食管超声心动图测量LAD，螺旋CT测量左上肺静脉（LSPV）、左下肺静脉（LIPV）、右上肺静脉（RSPV）和右下肺静脉（RIPV）的cT值及肺静脉变异情况。所有患者都成功进行经导管射频消融治疗，并在术后随访10个月。通过单因素和多因素Cox回归分析肺静脉结构特点，LAD及其他因素与术后复发的相关性。结果267例入选患者中，复发44例。复发组与无复发组相比，LAD、LSPV、RSPV、左侧总肺静脉和上侧总肺静脉平均直径明显增大（P〈0．05）。经单因素及多因素Cox回归分析显示LAD、上侧总肺静脉直径、房颤类型以及房颤病程是房颤射频消融术后复发的独立危险因素。结论LAD越大、上肺静脉开口越宽的房颤患者，经导管射频消融术后越容易复发，而病程较长和持续性房颤亦是房颤射频消融术后复发的独立预测因素。
Objective To investigate the roles of left atrial diameter （LAD） and anatomic structure characteristics of pulmonary veins （PV） for the prediction of postoperative recurrence after radiofrequency catheter ablation of atrial fibrillation. Methods For 267 atrial fibrillation （AF） patients treated by radiofrequency catheter ablation, the anatomic structure characteristics of pulmonary veins were assessed by mutislicespiral CT while the values of left atrial diameter were measured with transesophageal ultrasonic cardiogram. After radiofre- quency catheter ablation, postoperative recurrence of AF was evaluated during a 10-month term follow-up. Resuits During follow-up,postoperative recurrence of AF occurred in 44 patients. The mean diameters of LAD, left superior PV, right superior PV, all left PV, and all superior PV were significantly larger in patients with postoperative recurrence （ all P〈O. 05 ）. Muhivariable survival analysis showed that the type and the course of atrial fibrillation, LAD, and the diameters of all superior PVwere the independent risk factors for the postopera- tive recurrence of AF. Conclusion The enlargements of left atrial and all superior PV,long course of diseases and persistent atrial fibrillation were the independent risk factors for the postoperative recurrence of atrial fibrillation.
出处
《中华心律失常学杂志》
2012年第3期206-210,共5页
Chinese Journal of Cardiac Arrhythmias
关键词
心房颤动
射频导管消融
肺静脉
左心房内径
复发
Atrial fibrillation
Radiofrequeney catheter ablation
Pulmonary vein
Left atrial diameter
Postoperative recurrence
