慢性心房颤动射频消融术后应用氯沙坦联合胺碘酮治疗对心房颤动复发及心房结构的影响

目的观察慢性心房颤动射频消融术后口服氯沙坦联合胺碘酮治疗对心房颤动复发及心房结构的影响。方法拟行射频消融治疗的慢性心房颤动患者100例,随机分为射频消融组50例和射频消融+药物组(氯沙坦联合胺碘酮)50例。术后行动态心电图检查确定心律失常发作情况,超声心动图复查心脏结构和功能。结果电学隔离后15例患者转为窦性心律(射频消融组8例,射频消融+药物组7例),每组各有4例患者转为三尖瓣峡部相关心房扑动,消融三尖瓣峡部后转为窦性心律。其他患者通过进一步消融及电复律转为窦性心律。与射频消融组比较,射频消融加药物组术后1 a左心房前后径减小,而心功能无明显变化。随访过程中射频消融组心房颤动复发率为60.0%,射频消融加药物组心房颤动复发率为32.0%,2组比较差异有统计学意义(P<0.05)。结论慢性心房颤动射频消融术后口服氯沙坦联合胺碘酮可有效维持窦性心律,使左心房前后径减小。

Effect of losartan combined with amiodarone on recurrence and atrium structer of chronic atrial fibrillation after radiofrequency catheter ablation

Objective To investigate the efficacy of losartan combined amiodarone treating on chronic atrial fibrillation after radiofrequency catheter ablation and the influence for recurrence and heart atrium structer.Methods A total of 100 patients with chronic atrial fibrillation who was going to had catheter ablation were selected and randomly divided into two groups:radiofrequency catheter ablation group(n=50) and radiofrequency catheter ablation+medicine group(n=50).The arrhythmia was observed by ambulatory electrocardiogram and the structer and function of heart was observed by echocardiogram after operation.Results Fifteen patients changed into sinus rhythm after operation including 8 cases in radiofrequency catheter ablation group and 7 cases in radiofrequency catheter ablation + medicine group.There were 4 cases with ablation in isthmus between tricuspid valve annulus and inferior vana cava in the 2 groups respectively.The other patients were converted by electric cardioversion.Compared with radiofrequency catheter ablation group,both the left atrial diameter and the recurrence rate of atrial fibrillations decreased significantly in radiofrequency catheter ablation + medicine group in the following-up of 12 months(P<0.05),and the heart function had no significant change.Conclusion Losartan combined with amiodarone can decrease the recurrence rate of atrial fibrillation and left atrial diameter in chronic atrial fibrillation after radiofrequency catheter ablation.