导管消融治疗持续性心房颤动伴左室功能不全的初步随访Primary follow-up of catheter ablation for atrial fibrillation in patients with left ventricular dysfunction
孙育民,刘旭,王新华,施海峰,顾佳宁,周立,胡伟,方唯一
摘要(Abstract)：
目的评价导管消融治疗持续性心房颤动伴左室功能不全的疗效。方法回顾分析连续10例接受导管消融的持续性心房颤动伴左室功能不全患者,短期随访观察术前、术后心功能的改变。结果9例患者成功完成导管消融术,术前平均左室射血分数(LVEF)0·41±0·01,左室舒张末期内径(LVEDD)56·00±7·21mm,左心房内径(LAD)44·22±5·91mm。术后平均随访2·78±1·78个月,平均LVEF增为0·46±0·06,LVEDD降为53·33±6·42mm,LAD降为42·11±4·65mm,与术前相比差异有统计学意义(P<0·05)。结论在慎重选择病例的基础上,导管消融术治疗持续性心房颤动伴左室功能不全安全、有效。
关键词(KeyWords)： 心房颤动;心力衰竭,充血性;导管消融术;肺静脉
基金项目(Foundation):
作者(Author): 孙育民,刘旭,王新华,施海峰,顾佳宁,周立,胡伟,方唯一
参考文献(References)：
- [1]王冬梅,王祖禄,韩雅玲,等.充血性心力衰竭伴慢性心房颤动房室结消融及双心室同步起搏治疗半年疗效观察.中华心律失常学杂志,2004,8:383-384.
- [2]范洁,丁立群,周乐今,等.房室结消融及起搏器治疗改善心房颤动患者心功能和生活质量的研究.中国心脏起搏与心电生理杂志,2004,18:254-256.
- [3]Valls-Bertault V,Fatemi M,Gilard M,et al.Assessment of upgra-ding to biventricular pacing in patients with right ventricular pa-cing and congestive heart failure after atrioventricular junctional ablation for chronic atrial fibrillation.Europace,2004,6:438-443.
- [4]Mahoney P,Kimmel S,DeNofrio D,et al.Prognostic signifisance of atrial fibrillation in patients at a tertiary medical center referred for heart transplantation because of severe heart failure.Am J Cardiol,1999,83:1544-1547.
- [5]Al-Khatib SM,Shaw LK,Lee K,et al.Is rhythm control superior to rate control in patients with atrial fibrillation and congestive heart failure?Am J Cardiol,2004,94:797.
- [6]Chen MS,Marrouche NF,Khaykin Y,et al.Pulmonary vein isola-tion for the treatment of atrial fibrillation in patients with impaired systolic function.J Am Coll Cardiol,2004,43:1004-1009.
- [7]Hsu LF,Jais P,Sanders P,et al.Catheter ablation for atrial fibril-lation in congestive heart failure.NEngl J Med,2004,351:2373-2383.
- [8]Oral H,Pappone C,Chugh A,et al.Circumferential pulmonary-vein ablation for chronic atrial fibrillation.N Engl J Med,2006,354:934-941.
- [9]Ehrlich JR,Nattel S,Hohnloser SH.Atrial fibrillation and con-gestive heart failure:specific considerations at the intersection of two common and important cardiac disease sets.J Cardiovasc Electrophysiol,2002,13:399-405.