摘要
目的:探讨持续性心房颤动(房颤)射频消融术空白期后继续应用抗心律失常药物能否降低术后心房扑动、房性心动过速等房性心律失常的发生率。方法:在空白期结束后,将空白期后心律仍为窦性心律的患者分为试验组(应用抗心律失常药物胺碘酮或普罗帕酮至术后12个月)和对照组(停止应用胺碘酮及其他Ⅲ类和Ⅰ类抗心律失常药物),随访1年,对两组患者的远期成功率、房颤负荷和生活质量评分等进行比较。结果:试验组远期成功率与对照组相比无统计学差异(62.5%∶58.3%,P=0.534),但房颤负荷及生活质量评分在两组间有统计学差异(P<0.05)。房颤病史为房颤射频消融术后复发的危险因子(HR:1.013,95%CI:1.004～1.023,P=0.003)。结论:空白期后抗心律失常药物强化应用对持续性房颤术后复发影响甚微,但可降低房颤负荷及提高患者生活质量。房颤病史是持续性房颤射频消融术后远期复发的独立预测因子。
Objective:To investigate whether the intensive use of antiarrhythmic drugs after radiofrequency ablation of persistent atrial fibrillation can reduce the incidence of atrial arrhythmias such as atrial flutter and atrial tachycardia.Method:After the end of the blank period,patients whose rhythm remained sinus rhythm were divided into experimental group(using amiodarone or propafenone until 12 months after the operation)and control group(stopping using amiodarone and other classⅢ and classⅠ antiarrhythmic drugs).Following up for one year,the long-term success rate,atrial fibrillation load and quality of life score were compared between the two groups.Result:There was no difference in the long-term success rate (62.5%vs.58.3%,P=0.534),while there were significant differences in the trial fibrillation load and the quality of life score between the two groups(both P<0.05).The history of atrial fibrillation was a risk factor for recurrence after radiofrequency ablation (HR:1.013,95%CI:1.004-1.023,P=0.003).Conclusion:Intensive use of antiarrhythmic drugs after the radiofrequency ablation of persistent atrial fibrillation has little effect on the recurrence,but it can reduce the burden of atrial fibrillation and improve the quality of life.The history of atrial fibrillation is an independent predictor of long-term recurrence after radiofrequency ablation of persistent atrial fibrillation.
作者
赵子明
袁义强
尹晓盟
杨延宗
夏云龙
ZHAOZiming;YUAN Yiqiang;YIN Xiaomeng;YANG Yanzong;XIA Yunlong(Department of Cardiology,Henan Cardiovascular Hospital Affiliated to Southern Medical University,Zhengzhou,450000,China;Department of Arrhythmia,the First Affiliated Hospital of Dalian Medical University)
出处
《临床心血管病杂志》
CAS
北大核心
2019年第1期60-64,共5页
Journal of Clinical Cardiology
关键词
心房颤动
导管消融
抗心律失常药物
疗效
atrial fibrillation
catheter ablation
antiarrhythmic drugs
efficacy
