| 聂晶,万征,蔡衡,张文娟,于向东,姚薇,程晔,朱可佳.经导管消融治疗心房颤动伴心动过缓[J].中国医学影像技术,2012,28(7):1331~1334 |
| 经导管消融治疗心房颤动伴心动过缓 |
| Transcatheter radiofrequency ablation for treatment of atrial fibrillation and bradycardia |
| 投稿时间：2011-11-17 修订日期：2012-03-26 |
| DOI： |
| 中文关键词: 导管消融 心律失常,心脏的 心房颤动 窦房结 |
| 英文关键词:Catheter ablation Arrhythmias, cardiac Atrial fibrillation Sinoatrial node |
| 基金项目: |
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| 摘要点击次数: 2019 |
| 全文下载次数: 993 |
| 中文摘要: |
| 目的 探讨经导管消融治疗心房颤动合并心动过缓的方法和患者的安全性。方法 对24例心房颤动伴心动过缓患者行经导管消融治疗心房颤动,消融策略包括环肺静脉电隔离、左心房线性消融及复杂心房碎裂电位(CFAE)消融。观察消融前及术后1个月动态心电图,并记录24 h平均心率、最高窦性心率,以超声心动图评价术后6个月左心房直径变化。结果 心房颤动消融术后患者平均心率、最高窦性心率均高于术前(P<0.001);术后6个月左心房舒张末期直径减小(P<0.001)。经(19.8±9.9)个月门诊随访,15例(15/24,62.50%)无心房颤动复发,无缓慢型心律失常相关症状;6例患者仍有房性期前收缩或房性心动过速发作,1例患者因心动过缓植入起搏器治疗,余2例心房颤动发作较术前频度减少。结论 心房颤动转复时的窦性停搏和心动过缓以及部分快-慢综合征患者的窦房结功能不良可能是源于快速心房率对窦房结功能的抑制。对这部分患者行经导管消融治疗可安全、有效地改善窦房结功能不良,逆转重构。 |
| 英文摘要: |
| Objective To evaluate the safety and technique of transcatheter ablation for patients with atrial fibrillation and bradycardia. Methods Twenty-four patients with paroxysmal, persistent or long-standing atrial fibrillation (AF) and bradycardia underwent atrial fibrillation ablation. The procedures included circumferential pulmonary vein isolation, linear atrial ablation and complex fractionated atrial electrogram ablation. The mean and maximum heart rate before and 1 month after ablation were assessed by 24-hour ambulatory monitoring. Left atrium size was evaluated by echocardiography 6 months after ablation. Results After AF ablation, the mean heart rate and maximum heart rate were higher than before (all P<0.001), and left atrium size decreased at 6 months (P<0.001). During 19.8±9.9 months' follow-up, 15 patients (15/24, 62.50%) had no recurrence of AF nor symptoms attributable to bradycardia, 6 patients had infrequent episodes of atrial tachycardia or premature atrial contraction, 1 patient required pacemaker implantation, and 2 patients had infrequent attacks of AF. Conclusion Prolonged sinus pauses and bradycardia after paroxysms of AF together with some tachycardia-bradycardia syndrome may be resulted from depression of sinus node function that can be eliminated by curative ablation of AF. For patients in this situation, transcatheter radiofrequency ablation may be used to safely and effectively improve sinus node function and reverse remodeling of the sinus node. |
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