肺静脉电隔离术联合碎裂电位消融治疗持续性房颤疗效观察

目的：观察肺静脉电隔离术（ pulmonary vein isolation ， PVI ）联合碎裂电位（ complex fractionated atrial electrograms ， CFAE）消融对持续性房颤的疗效。方法对比观察23名于本院行房颤射频消融术的持续性房颤患者，所有患者均行PVI及左房顶部线性消融，其中12例联合CFAE消融，术后随访1年；观察两组手术时间、X线曝光时间、消融时间、手术并发症、左房大小、左房血栓、一次手术成功率等指标。结果联合CFAE消融组总手术时间（252±35） min、X线曝光时间（42±9．1）min、消融时间（94±11）min，单纯行PVI 组分别为（176±22）min、（34±7．6）min、（63±8）min，联合CFAE消融组手术各时间均明显延长（P＜0．01）；两组手术并发症、对左房大小及左房血栓的影响比较差异均无统计学意义；联合CFAE消融组一次手术成功率（75％）明显高于单纯行PVI组（64％）（ P＜0．05）。结论 PVI联合CFAE消融治疗持续性房颤虽增加手术、消融及X线曝光时间，但并不会提高并发症发生率，可提高房颤消融的一次手术成功率。

Curative effect evaluation of pulmonary vein isolation associated with complex fractionated atrial electrograms ablation in treating persistent atrial fibrillation

Objective To observe the effects of pulmonary vein isolation （ PVI） associated with complex fractionated atrial electrograms （ CFAE） ablation on patients with persistent atrial fibrillation （ AF） .Methods Twenty-three patients with persistent AF were enrolled in the study .All of them had been treated by PVI and linear ablation in left atrium , among whom 12 cases were additionally given CFAE ablation .During a one-year follow-up, several indexes were compared between the two groups , including the duration of operation , X-ray exposure time , ablation time , surgical complica-tions, internal diameter and thrombus of left atrium , success rate of once operation , etc.Results Compared with PVI group, the total time of operation [（176 ±22） min vs.（252 ±35） min], X-ray exposure time[（34 ±7.6） min vs.（42 ±9.1） min], and ablation time[（63 ±8） min vs.（94 ± 11） min] was significantly increased in PVI ＋CFAE group （ P〈0 .05 ） .The differences of surgical complications, and the influences on internal diameter and thrombus of left atrium were not statisti-cally significant .The success rate of once operation in PVI associated with CFAE ablation group was significantly higher than that in PVI group （75%vs.64%;P〈0.05）.Conclusion In the treatment of persistent atrial fibrillation , although PVI associated with CFAE ablation lengthens the time of operation , X-ray exposure time , and ablation time , it will not increase the incidence of complica-tions and can elevate the success rate of once operation in atrial fibrillation ablation .