摘要
目的比较射频导管消融(下称消融)的节律控制与药物室率控制对心房颤动患者心力衰竭的治疗效果。方法连续入选心房颤动合并心力衰竭患者35例(消融组),同期选择年龄、性别、心房颤动类型、基础疾病、左心房前后径(LAD)、左心室舒张末期内径(LVEDd)、左心室射血分数(LVEF)相匹配的药物室率控制加抗凝治疗的患者35例(室率控制组)。结果随访(24±12)个月,消融术后,57%(20/35)的患者维持窦性心律。消融组与药物室率控制组比较,其中心血管死亡事件发生率(5.71%vs 8.57%)差异无统计学意义(P>0 05),缺血性脑卒中发生率(2.86%vs 20.00%),NYHA心功能分级改善(68.57%vs 31.43%),LAD改变幅度[(-8±8)mm vs(9±12)mm],LVEDd改变幅度[(-5±7)mm vs(0±7)mm],LVEF提高幅度[(21%±12)%vs(10%±15%)]差异均有统计学意义(均P<0.05或0.01)。结论合并心力衰竭的心房颤动患者,经导管消融的节律控制优于药物室率控制。
Objective To compare the effect of catheter ablation and rate control strategy on heart failure （HF）of pa-tients with atrial fibril ation （AF）. Methods 35 consecutive patients with AF and HF underwent catheter ablation（ablation group） and 35 similar patients received pharmacologic rate control and anticoagulation therapy （rate control group）. Re-sults After a mean fol ow up of 24 ±12 months, sinus rhythm was seen in 57.14%（20 / 35） of the patients underwent catheter ablation. Compared with rate control group, ablation group had significantly less stroke events （2.86% vs. 20.00%, P〈0.05）, more significantly improved NYHA class （68.57% vs. 31.43%, P〈0.01）, decreased left atrial diameter （- 8±8mm vs. 9±12mm, P〈0.01） and left ventricular end diastolic diameter （- 5±7mm vs. 0±7mm, P〈0.01）, and in-creased left ventricular ejection fraction （21%±12%vs. 10%±15%, P〈0.01）. There was no significant difference of car-diac death between ablation group （5.71%） and rate control group （8.57%）（P〉0.05）. Conclusion Rhythm control by catheter ablation is superior to pharmacologic rate control in improving heart function of patients with AF.
出处
《心电与循环》
2013年第5期382-384,392,共4页
Journal of Electrocardiology and Circulation
关键词
心房颤动
心力衰竭
导管消融
室率控制
Atrial fibrillation
Heart failure
Catheter ablation
Rate control
