摘要
目的评估导管消融术对药物治疗无效的阵发性心房颤动的疗效,并探讨其复发的相关因素。方法选择2012年1月至2014年12月期间药物治疗无效而首次行导管消融术治疗的阵发性心房颤动532例,随访12个月,评估导管消融术的疗效,探讨术后复发的相关因素。结果 532例阵发性心房颤动均完成双侧环肺静脉电隔离术,即刻消融成功率100%。随访12个月,416例(78.2%)维持窦性心律(未复发组),116例(21.8%)复发(复发组)。空白期内早期复发有94例,随访12个月,其中64例(68.1%)远期复发,30例(31.9%)维持窦性心律。20例(3.8%)发生导管消融术相关的并发症,其中手术穿刺部位血肿13例(2.4%),股动脉假性动脉瘤4例(0.8%),股动静脉瘘3例(0.6%),对症治疗后均痊愈。左心房内径扩大、早期复发是阵发性心房颤动导管消融术后远期复发的独立预危险因素(均P<0. 01)。结论阵发性心房颤动导管消融术是安全有效的治疗手段。左心房内径扩大、早期复发是导管消融术后远期复发的独立危险因素。
Objective To evaluate the long-term efficacy of catheter ablation for paroxysmal atrial fibrillation(PAF)and to analyze the risk factors of disease recurrence.Methods Total 532 patients with PAF,who underwent catheter ablation in our hospital between January 2012 and December 2014,were enrolled in the study.The patients were followed up for 12 months,the efficacy of catheter ablation was evaluated and risk factors related to recurrence were analyzed.Results During 12-months following catheter ablation,416 cases(78.2%)maintained sinus rhythm with no antiarrhythmic drug therapy,116 cases(21.8%)had recurrence of atrial fibrillation.94 cases were early recurrence in the blank period,among which 64 cases(68.1%)had long-term recurrence and 30 cases(31.9%)maintained sinus rhythm.Twenty patients(3.8%)had complications associated with catheter ablation,including puncture site hematoma(n=13),pseudoaneurysm(n=4)and femoral venous fistula(n=3),all were cured after treatment.Univariate and multivariate analysis showed that larger left atrial dimension and early recurrence were the independent risk factors of late recurrence after catheter ablation(P<0.001).Conclusion Catheter ablation is a safe and effective treatment for PAF.Larger left atrial dimension and early recurrence are the factors related to late recurrence after catheter ablation.
作者
林建伟
蒋汝红
刘强
张培
于路
盛夏
傅国胜
蒋晨阳
LIN Jianwei;JIANG Ruhong;LIU Qiang(Department of Cardiology,Sir Run Run Shaw Hospital,Zhejiang University School of Medicine,Hangzhou 310016,China)
出处
《浙江医学》
CAS
2019年第4期328-331,共4页
Zhejiang Medical Journal
关键词
阵发性心房颤动
导管消融
复发
Paroxysmal atrial fibrillation
Catheter ablation
Recurrence
