杨汪洋,李松南,金达,刘念,白融,杜昕,董建增,马长生

• 1:首都医科大学附属北京安贞医院心内科房颤中心

摘要(Abstract)：

目的分析植入起搏器的心房颤动(房颤)患者导管消融术后远期窦性心律的维持情况。方法选取2008年1月至2014年10月在北京安贞医院房颤中心首次接受导管消融的房颤合并植入起搏器的患者65例作为起搏器+房颤组;从同期在本中心因房颤首次接受导管消融术治疗的非起搏器状态患者中,按照1∶4比例进行性别、年龄、房颤类型匹配选取260例患者作为房颤组。结果起搏器+房颤组与房颤组共325例,平均随访(36.6±20.3)个月。阵发性房颤患者中起搏器+房颤组患者复发率为60.5%,房颤组患者复发率为38.8%,Kaplan-Meier分析两者之间差异有统计学意义(P=0.005);进一步行Logistic回归分析发现,性别、植入起搏器、左心房前后径为阵发性房颤患者消融术后复发房颤的独立预测因素。持续性房颤患者中起搏器+房颤组患者复发率为55.6%,房颤组患者复发率为58.3%,Kaplan-Meier分析两者之间差异无统计学意义(P=0.925);分析持续性房颤患者各项基线资料发现,仅左心房前后径与远期预后有关,是否植入起搏器并不影响手术成功率。结论导管消融术对于植入起搏器的房颤患者是安全有效的,然而不同类型房颤消融效果受起搏器影响不同,植入起搏器的持续性房颤患者术后远期窦性心律维持率或与非起搏器状态患者相当,植入起搏器的阵发性房颤患者远期预后则较非起搏器状态患者差。

关键词(KeyWords)： 心房颤动;起搏器;导管消融

Abstract:

Keywords:

基金项目(Foundation): 2013年度重点医学专业-心律失常北京市医院管理局临床医学发展专项(ZYLX201302);; “十二五”国家科技支撑计划“中国心律失常注册研究”(2013BAI09B02)

作者(Author): 杨汪洋,李松南,金达,刘念,白融,杜昕,董建增,马长生

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