肺静脉电隔离术后房性心律失常风暴现象的机制及对策The “atrial arrhythmic storm” phenomenon after segmental pulmonary veins isolation in patients with paroxysmal atrial fibrillation
丁燕生,杨俊娟,李康,龚艳君
摘要(Abstract):
目的回顾分析阵发心房颤动(房颤)肺静脉电隔离术后早期房颤频繁复发并加重的病例,研讨此现象发生的机制和治疗对策。方法对连续54例药物治疗无效的阵发性房颤患者行肺静脉电隔离术,观察术后两周内的房颤复发情况。结果消融术后两周内10例(18.5%)有房颤早期复发或合并快速房性心律失常发作,其中4例(7.4%)出现肺静脉电隔离术后房性心律失常风暴现象。此4例患者联合使用抗心律失常药物两周左右心律逐渐恢复正常,继续服药至3个月,停药后房性心律失常风暴患者仅有1例仍有房颤发作,行二次肺静脉电隔离消融术,术后无房颤发作。结论消融术后早期房颤发作较常见,少数患者短期内房颤发作更加频繁,表现为房性心律失常风暴现象。其可能为多种因素联合作用所致,联合抗心律失常药物治疗有效,不必急于短时间内二次消融。
关键词(KeyWords): 心房颤动;导管消融术;房性心律失常风暴
基金项目(Foundation):
作者(Author): 丁燕生,杨俊娟,李康,龚艳君
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