熊玉玲,王志燕,华畅,汤阳阳,刘欣茹,吕强,董建增,杜昕

• 1:首都医科大学附属北京安贞医院心力衰竭中心

摘要(Abstract)：

目的 探讨左心室射血分数（LVEF）≤35%心力衰竭合并持续性心房颤动或心房扑动患者行导管射频消融的安全性和有效性。方法 回顾性纳入2018年1月至2024年3月期间在首都医科大学附属北京安贞医院心力衰竭中心接受导管射频消融治疗的心力衰竭（LVEF≤35%）合并持续性心房颤动/心房扑动患者，分析患者消融特征、围术期并发症、超声心动图参数变化和随访结局等。结果 共纳入45例患者，平均年龄为（56±13）岁，术前平均LVEF为（28±4）%。消融策略为双肺静脉电隔离加经验性线性消融，手术时间和透视时间分别为120(120,163)min和5(4,10)min，入选患者主要进行了环肺静脉隔离38例（84.4%）、三尖瓣环峡部线37例（82.2%）、左心房顶部线34例（75.6%）、二尖瓣环峡部线34例（75.6%）及Marshall静脉无水酒精化学消融21例（46.7%）等线性消融，24例（53.3%）患者术中行电复律转复。所有患者术后即刻均恢复窦性心律，且均未发生围术期并发症。中位随访22.9 (7.8,31.0)个月，2例患者心血管死亡，1例患者接受了心脏移植，14例（33.3%）患者因心血管疾病再次住院，10例（23.8%）患者心房颤动复发。末次随访获得LVEF的28例患者平均LVEF从术前（28±4）%上升至术后（51±14）%,LVEF平均改善为（23±13）%(P<0.0001)，其中15例患者左心室收缩功能完全恢复（LVEF≥50%）。结论 对于心力衰竭（LVEF≤35%）合并持续性心房颤动/心房扑动患者，接受导管射频消融安全有效，能改善患者心功能，显著提高LVEF。

关键词(KeyWords)： 心力衰竭;心房颤动;导管射频消融;心功能;左心室射血分数

Abstract:

Keywords:

基金项目(Foundation): 北京市自然科学基金项目（171100006817001）

作者(Author): 熊玉玲,王志燕,华畅,汤阳阳,刘欣茹,吕强,董建增,杜昕

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