中国全科医学2012，Vol.15Issue(16)：1821-1824,4.DOI:10.3969/j.issn.1007-9572.2012.06.014
不同类型心房颤动导管消融治疗的对比研究
Comparison of Effectiveness and Safety of Catheter Ablation for Different Types of Atrial Fibrillation
聂晶 1蔡衡 1万征 1张文娟 1姚薇 1程晔 1张亮 1朱可佳1
作者信息
- 1. 300052,天津市,天津医科大学总医院心血管内科
- 折叠
摘要
Abstract
Objective To evaluate the effectiveness and safety of catheter ablation under three - dimensional mapping system for paroxysmal, persistent and long - standing atrial fibrillations ( AF ) . Methods Fifty - five patients with persistent or long - standing AF who underwent catheter ablation between January 2008 and December 2010 in our hospital were enrolled into group A, and another 55 patients with paroxysmal AF into group B. Catheter ablation was conducted under CARTO or Ensite 3000 three - dimensional mapping system using CARTO - Merge or Ensite Fusion technique, stepwise ablation for group A and circumferential pulmonary vein isolation for group B. Warfarin intake was continued and antiarrhythmic agents were stopped after the procedure. Follow - ups were carried out at three and six months after the procedure using DCG to monitor the cardiac rhythm; echocardiography was used to evaluate the diameter of the left atrium at six months after the procedure. Results In group A, 17 ( 30. 9% ) patients regained sinus rhythm during ablation, AF turned into atrial flutter in 29 ( 52. 7% ) patients during ablation, and 9 still needed direct current countershock after ablation. In group B, 18 patients had AF episode during ablation and regained sinus rhythm under different treatment ( 13 by circumferential pulmonary vein isolation, 2 by high - frequency stimuli, and 3 by propafenone ). The three - month follow - up results showed 29 cases of atrial tachycardia, 9 atypical atrialflutter, and 13 AF in group A, and 16 cases of atrial tachycardia, 8 atypical atrial flutter, and 8 AF in group B. The six -month follow - up results showed 19 cases of AF reoccurrence in group A and 7 in group B. The non - reoccurrence rate of group B ( 87. 3% ) was significantly higher than that of group A ( 65. 5% ). Conclusion Catheter ablation is safe for persistent and long - standing AF, but longer and more complex with longer X - ray exposure and lower initial non - recurrence rate than that for paroxysmal AF. Macroreentrant atrial fibrillation and atypical atrial flutter are common after catheter ablation and may be alleviated or even disappeared at three months after the procedure. The decrease of left atrial volume after effective catheter ablation for persistent and long - standing AF indicates chances of atrial remodeling.关键词
心房颤动/导管消融/电生理学Key words
Atrial fibrillation/ Catheter ablation/ Electrophysiology分类
医药卫生引用本文复制引用
聂晶,蔡衡,万征,张文娟,姚薇,程晔,张亮,朱可佳..不同类型心房颤动导管消融治疗的对比研究[J].中国全科医学,2012,15(16):1821-1824,4.
