刘俊,唐闽,Jan Kaufmann,Charalampos Kriatselis,Eckart Fleck,李劲宏,方丕华,张澍

• 1:中国医学科学院心血管病研究所 北京协和医学院阜外心血管病医院心律失常诊治中心
• 2:德国心脏病中心(柏林)心内科

摘要(Abstract)：

目的分析冷冻球囊消融(CBA)治疗心房颤动(房颤)患者的单中心长期随访效果,探讨影响其疗效的相关临床因素。方法回顾性分析2009年1月至2013年4月接受CBA治疗的房颤患者的住院病历资料、手术记录和门诊随访资料。术前经胸超声测量左心房内径(LAD)。术后3个月后出现的房颤、心房扑动(房扑)、房性心动过速(房速)发作判定为CBA治疗失败。结果 199例房颤接受CBA治疗,术中并发膈神经麻痹3例(1.5%),术后发生心包积液1例(0.5%)、短暂性脑缺血发作1例(0.5%),均自行缓解。在平均(23±14)个月随访中152例患者完成随访,其中65例(42.8%)治疗成功,失败患者中75例(86.2%)为术后12个月内复发。失败患者年龄较大[(62±7)比(52±10),P=0.0379]、LAD较大[(47±7)mm比(43±6)mm,P<0.0001],持续性房颤患者治疗成功率(29.5%)明显低于阵发性房颤患者(48.1%)。Logistic回归分析显示年龄[OR=1.037(1.000,1.076),P=0.0488]和LAD[OR=0.896(0.842,0.953),P=0.005]能独立预测初次CBA治疗效果。结论 CBA治疗房颤安全有效,长期随访效果较好。房性心律失常复发主要发生在术后12个月内。年龄和LAD是预测术后复发的独立危险因素。

关键词(KeyWords)： 冷冻球囊;冷冻消融;心房颤动;长期随访

Abstract:

Keywords:

基金项目(Foundation): 北京市科技计划项目(2012BKJ09)

作者(Author): 刘俊,唐闽,Jan Kaufmann,Charalampos Kriatselis,Eckart Fleck,李劲宏,方丕华,张澍

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