郑素琳,詹贤章,薛玉梅,方咸宏,廖洪涛,邓海,魏薇,廖自立,刘方舟,刘洋,梁远红,吴书林

• 1:广东省心血管病研究所心内科广东省人民医院广东省医学科学院

摘要(Abstract)：

目的评价导管消融治疗迷宫术后复发房性心动过速(房速)的中、远期疗效,探讨房速复发的相关因素。方法纳入2010年4月至2015年6月在广东省人民医院接受导管消融治疗的迷宫术后复发房速患者59例。应用三维标测系统进行高密度电解剖标测,结合拖带标测指导导管消融。术后定期随访,采用多因素Cox比例风险回归模型分析导管消融治疗迷宫术后房速复发的危险因素。结果共记录到88种房速,其中1例患者房速为短阵性发作,与窦性心律交替出现,难以进行电解剖标测及拖带标测。平均每例患者有(1.49±0.75)种房速,以折返性房速多见,占76.1%(67/88),局灶性房速占22.7%(20/88)。59例患者中,56例(94.9%)即时消融成功。术后平均随访(30.8±17.7)个月,首次导管消融治疗后3例患者即时消融失败,12例复发,术后复发时间为3.5(1.3,12.0)个月,消融成功率为74.6%(44/59)。6例患者接受再次导管消融治疗,二次导管消融治疗后总体成功率为79.7%(47/59)。多因素分析提示左心房内径为预测复发的独立危险因素(HR1.108,95%CI 1.002~1.226,P=0.045)。结论迷宫术后复发房速患者行导管消融治疗安全、有效,左心房内径是房速消融术后复发的独立危险因素。

关键词(KeyWords)： 心房颤动;外科迷宫术;房性心动过速;导管消融

Abstract:

Keywords:

基金项目(Foundation): 广州市科技计划(2014Y-00196,158100073)

作者(Author): 郑素琳,詹贤章,薛玉梅,方咸宏,廖洪涛,邓海,魏薇,廖自立,刘方舟,刘洋,梁远红,吴书林

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