环肺静脉消融电隔离治疗持续性心房颤动的疗效观察The clinical evaluation of circumferential pulmonary vein isolation in cases with persistent atrial fibrillation
王新华,刘旭,顾佳宁,周立,高东升,胡伟,邱建华
摘要(Abstract)：
目的评价EnSite-NavX系统引导下环肺静脉消融电隔离结合左心房线性消融治疗持续性/永久性心房颤动(房颤)的安全性和疗效。方法入选2004年9月至2005年8月持续性/永久性房颤患者60例,男性43例,女性17例,平均年龄59.2±13.6(39~77)岁,平均房颤持续时间4±6年(6个月~24年)。左心房内径43.2±6.4(42~58)mm。在EnSite-NavX系统引导下行环肺静脉消融达到肺静脉电隔离,并进行左心房后壁和二尖瓣峡部线性消融。结果60例均顺利完成手术。平均手术时间170±34(150~240)min,X线透视时间23±10(12~45)min。环左肺静脉消融电隔离率为83.3%,环右肺静脉消融电隔离率为78.3%,其余病例结合节段性消融达到肺静脉电隔离。消融终止房颤7例;转变为房性心动过速(房速)/心房扑动(房扑)5例,其中2例消融终止。48例电转复成功,术后房扑/房速10例(16.7%),8例自愈,2例再次消融成功。术后平均随访6.5±3.2(4~11)个月,43例(71.7%)无房颤发作(其中18例服用抗心律失常药物)。并发症:股动脉假性动脉瘤1例,经保守治疗痊愈。结论EnSite-NavX系统引导下环肺静脉消融电隔离结合左心房线性消融治疗持续性/永久性房颤安全性好,疗效可以接受。
关键词(KeyWords)： 心房颤动;导管消融术;肺静脉
基金项目(Foundation):
作者(Author): 王新华,刘旭,顾佳宁,周立,高东升,胡伟,邱建华
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