心脏瓣膜手术同期行射频消融术后血栓和出血事件发生率的研究

目的:研究心脏瓣膜手术同期行射频消融术治疗永久性心房纤颤(房颤)术后脑血管事件的发生。方法:回顾2003年1月至2006年12月758例瓣膜病合并房颤病例,其中行瓣膜手术+房颤射频消融374例(射频消融组),仅行瓣膜手术384例(对照组)。术后随访6～54个月,平均(32±6.23)个月,对比分析2组病例术后脑血管事件随访数据。结果:术后随访证实消融组在术后脑血管事件发生率、生存率、窦性心律转复率等均优于对照组。结论:心脏瓣膜置换术同期行射频消融术治疗永久性房颤的远期疗效确切,可降低脑血管事件的发生,并提高远期生存率、窦性心律转复率。

Long-term outcome of reduced incidence of embolism and/or hemorrhage after intra-operative radiofrequency ablation in patients with atrial fibrillation undergoing concomitant cardiac valve surgery

Objective：To assess the long-term outcome of cerebrovascular accident after intra-operative radiofrequency （RF） ablation of atrial fibrillation （AF） in patients undergoing cardiac valve surgery. Methods： From January 2003 to December 2006,758 adults with permanent AF underwent cardiac valve replacement. Patients were divided into two groups： the RF group-374 patients qualified for cardiac valve surgery and RF ablation; and the control group-384 patients selected for cardiac valve surgery without ablation. Median follow-up was 6-54 （32 ± 6. 23） months. Results：Compared with the control group,the RF group showed significant better outcome in cerebral hemorrhage/stroke incidence,survival and sinus rhythm restoration. Conclusion：Optimal long-term outcome can be achieved by intra-operative radiofrequency ablation in patients with permanent atrial fibrillation undergoing concomitant cardiac valve surgery,in lower incidence of cerebrovascular accident and higher survival rate,compared with control group.