摘要
目的调查从事心脏电生理一线工作的医师若罹患非阵发性心房颤动(房颤),其相关治疗的选择,以期找寻心脏电生理医师自身认可的最合理的治疗方法。方法设计网络调查问卷,调查内容主要包括参与调查的医师一般情况(如性别、年龄、学历等)、若罹患非阵发性房颤后的治疗策略、导管消融术中选择、导管消融术后治疗策略的选择。2021年6月至2021年7月将问卷分享至全国多个较大规模的心脏电生理医师微信群进行调查并分析,调查对象为从事导管消融工作的一线心脏电生理医师。结果回收问卷387份,其中有效问卷195份。54.9%(107/195)心脏电生理医师选择导管消融治疗,35.9%(70/195)选择药物治疗无效后导管消融治疗策略。90.9%(161/177)的受访医师选择射频消融。射频消融具体策略选择:单纯肺静脉电隔离占24.9%(44/177);肺静脉电隔离加窦性心律下基质改良占22%(39/177);肺静脉电隔离加后壁盒状消融占11.9%(21/177);两圈三线消融策略占9.6%(17/177);肺静脉电隔离加房顶线消融占7.9%(14/177);肺静脉电隔离加转子消融占6.8%(12/177)。如果有抗栓治疗指征时,92.8%(181/195)的受访者选择非维生素K拮抗剂口服抗凝药(NOAC),6.7%(13/195)选择华法林,0.5%(1/195)选择抗血小板药物。结论导管消融治疗策略为大多数心脏电生理一线医师认可的房颤治疗方法,抗拴方案则首选NOAC。
Objective To survey the treatment options of cardiac electrophysiologists if they suffered from non-paroxysmal atrial fibrillation,including the selection of catheter ablation methods and the application of related drugs,in order to find the most reasonable treatment method approved by cardiac electrophysiologists themselves.Methods A network questionnaire was designed,which mainly included the general situation of the physicians participating in the survey(such as gender,age,education,etc.),the treatment strategy of non paroxysmal atrial fibrillation,the choice of catheter ablation,and the choice of treatment strategy after catheter ablation.From June 2021 to July 2021,the questionnaire was shared with many large-scale WeChat groups of cardiac electrophysiologists across the country for investigation and analysis.The respondents are first-line cardiac electrophysiologists engaged in catheter ablation.Results A total of 387 questionnaires were recovered,and 195 were valid.54.9%(107/195)cardiac electrophysiologists chose catheter ablation,35.9%(70/195)chose catheter ablation strategy after drug therapy failed.90.9%(161/177)of the interviewees chose radiofrequency ablation.Individual catheter ablation strategies during index ablation procedure included:pulmonary vein electrical isolation 24.9%(44/177);pulmonary vein electrical isolation plus substrate modification under sinus rhythm 22%(39/177);pulmonary vein electrical isolation plus posterior wall box ablation 11.9%(21/177);2C3L ablation strategy 9.6%(17/177);pulmonary vein electrical isolation plus roof line ablation 7.9%(14/177);pulmonary vein electrical isolation plus rotor ablation 6.8%(12/177).More than 90%respondents(92.8%,181/195)would take non-vitamin K antagonist oral anticoagulants(NOAC),6.7%(13/195)warfarin,and only 0.5%(1/195)antiplatelet drug if the anticoagulation indications were determined.Conclusion Most of the respondents will choose catheter ablation and NOAC as their treatment strategy if they suffer from non-paroxysmal atrial fibrillation.
作者
曹宾
郭瑛
夏盼盼
刘佳榛
王骏
孙育民
Cao Bin;Guo Yin;Xia Panpan;Liu Jiazhen;Wang Jun;Sun Yumin(Department of Cardiology,Jing'an Central Hospital,Shanghai 200040,China)
出处
《中华心脏与心律电子杂志》
2023年第3期147-153,共7页
Chinese Journal of Heart and Heart Rhythm(Electronic Edition)
关键词
心脏电生理学
心房颤动
治疗
导管消融
问卷调查
Cardiac electrophysiology
Atrial fibrillation
Treatment
Catheter ablation
Questionnaire survey
