摘要
目的:研究心房双极电压对心房颤动(房颤)患者射频消融结果的影响。方法:入选213例接受由CARTO系统引导的环肺静脉隔离术的房颤患者,其中持续性房颤患者77例,阵发性房颤患者136例。在CARTO指导下行环肺静脉电隔离。消融前窦律下标测得到电解剖图像,记录平均电压幅度等。消融后进行为期(12±7)个月的随访,同时分析这些患者的临床资料如性别、房颤持续时间、左房大小、基础疾病(高血压等)等。结果:阵发性房颤组成功者较复发者双极电压高[(1.77±1.01)∶(1.29±0.93)mV,P=0.048],低电压区比例低(P=0.011)。持续性房颤组成功者较复发者双极电压也高[(1.31±0.96)∶(0.78±0.35)mV,P=0.046],低电压比例降低(P=0.008)。结论:无论对于阵发性房颤还是持续性房颤,消融复发患者均较成功患者的心房电压下降、瘢痕点和低电压区面积增多,易于房颤的产生和维持。进一步证实了心房基质变化可能是导致房颤消融复发的一个重要因素。
Objective：To access the impact of atrial electroanatomical characteristics on the outcome of catheter ablation in patients with atrial fibrillation（Af）. Method：This study included 213 patients who underwent circumferential pulmonary vein isolation of Af,guided by a CARTO mapping system.The subjects were divided into two groups according to their Af type,as follows： Group Ⅰ： paroxysmal Af ablated in sinus rhythm（n=136）,Group Ⅱ： persistent Af（n=77）,each group was divided into two subgroup according to their ablation result.The mean voltage was obtained by using a CARTO mapping system before ablation.Several parameters,including the gender,Af duration,left atrial（LA） diameter,and underlying disease were analyzed. Result：In Group Ⅰ,the recurrence group had a significiantly higher LA bipolar voltage compared with the successful patients.（[1.29±0.93] vs [1.77±1.01]mV,respectively,P=0.048）.The LA bipolar voltage exhibited a significiant reduction and more low-voltage-zone was observed（P=0.011）.In Group Ⅱ,the LA bipolar voltage exhibited a significant reduction（[0.78±0.35] vs [1.31±0.96]mV,P=0.046,respectively）,and more low voltage zone（P=0.008） could be observed in patients in the recurrence group,which was similar to that of Group Ⅰ. Conclusion：Atrial substrate,including LA bipolar voltage,exhibits an important impact on the outcome of catheter ablation in patients with Af.
出处
《临床心血管病杂志》
CAS
CSCD
北大核心
2011年第8期609-612,共4页
Journal of Clinical Cardiology
关键词
心房颤动
电压标测
导管消融
复发
atrial fibrillation
voltage mapping
catheter ablation
recurrence
