瓣膜置换同时射频消融隔离肺静脉治疗风湿性瓣膜性心脏病永久性房颤

目的观察瓣膜置换同时肺静脉隔离治疗风湿性瓣膜性心脏病永久性房颤的疗效。方法风湿性瓣膜性心脏病瓣膜置换手术中合并房颤患者34例，17例消融组，17例对照组，消融组运用自制射频消融圈分别对4个肺静脉进行射频消融，术后随访，了解手术疗效。结果两组临床基线一致，平均随访（9．9±2．2）个月，消融组房颤转复率52．9％，对照组房颤转复率17．6％，两组差异有统计学显著意义（P〈0．05）。结论心内膜射频消融隔离肺静脉能安全、较有效地治疗风湿性瓣膜性心脏病永久性房颤。

Valve replacement combined with radiofrequency ablating the orifices of pulmonary veins for treatment of permanent atrial fibrillation in rheumatic heart disease

Objective To observe the efficacy of pulmonary veins isolation with radiofrequency endocardium ablation in patients with rheumatic heart disease and permanent atrial fibrillation（AF）. Methods Thirty-four patients who suffered from rheumatic valve disease and underwent mitral or mitral and aortic valve replacement were selected and divided into 2 groups, namely ablating group （n=17） and control group （n=17）. The pulmonary veins of ablating group patients were ablated with self-made radiofrequency ablation circle while the control goup was not. All patients were followed up with ECG and echocardiography for internal left atrial diameter, and left ventricular ejection fraction. Results The clinical baseline of the two groups and the time of cardiopulmonary bypass had no statistically significant difference （P〉0. 05）. In ablating group, sinus rhythm was achieved in 52.9% of the patients during 9.9±2.2 month follow-up, compared with 17.6% in the control group, with statistically significant difference （P= 0. 037） between the two groups. Conclusion Radiofrequency ablation of endocardium for isolation of pulmonary veins was effective for treatment of permanent AF in rhematic heart disease.