环肺静脉电隔离联合左心房线性消融治疗阵发性心房颤动的临床研究

目的 探讨环肺静脉电隔离联合左心房线性消融治疗阵发性心房颤动(PAF,简称房颤)的临床效果与安全性.方法 选择23例PAF患者,应用Ensite3000 Navx系统和Lasso电极指导下行环肺静脉电隔离及左房顶部线、峡部线消融.消融终点为:在消融过程中房颤终止,且肺静脉电位消失,或房颤不终止,但肺静脉电位消失;若在窦律下消融,肺静脉电位消失;左心房顶部及峡部线达到完全阻滞.结果 23例PAF患者均顺利完成手术,手术时间234～297 min,平均(277±41)min,X线暴光时间29～55 min,19例患者术中出现房颤,其中14例在消融过程中房颤终止且达到肺静脉电隔离,另外5例消融过程中房颤未终止,但肺静脉完全隔离.4例患者在窦性心律下完成了肺静脉电隔离.左心房顶部线全部达到完全阻滞,峡部线有2例未能达到完全阻滞.随访期间发现3个月后有86.9%的患者房颤消失或明显减少.结论 环肺静脉电隔离联合左心房线性消融治疗PAF 安全、可靠.Abstract：Objective To study the clinical efficacy and safety of circumferential pulmonary vein isolation of paroxysmal atrial fibrillation(PAF) combined with left atrial linear lesion. Methods Twenty-three PAF patients were performed circumferential pulmonary vein isolation combined linear lesion of left atrial isthmus and loof with Ensite 3000 Navx and Lasso electrodes guiding. Radiofrequency end point, atrial fibrillation stopped and pulmonary vein potentials(PVPs) disappeared, or atrial fibrillation did not stop, but PVPs disappeared. PVPs disappeared if atrial fibrillation was ablated during sinus rhythm. Left atrium loof and isthmus line were complete block.Results Twenty-three PAF patients were performed ablation, operation times were from 234 to 297 minutes, X ray time was from 29 to 55 minutes, 19 atrial fibrillations occurred during operation, of which 14 atrial fibrillations stopped with pulmonary vein isolation and linear lesion, the other 5 atrial fibrillations didn't stop, but which pulmonary veins were isolated. Tour patients were performed pulmonary vein isolation during sinus rhythm. All roof lines were completely block, and 2 left atrial isthmus lines were not completely block. 86.9% patients' atrial fibrillation disappeared or decreased significantly.Conclusions It is safe and efficient to treat PAF with circumferential pulmonary vein isolation combined with left atrial linear lesion.

Clinical study of circumferential pulmonary vein isolation combined with left atrial linear lesion of paroxysmal atrial fibrillation

Paroxymal atrial fibrillation Circumferential pulmonary vein isolation Left atrial linear lesion Radiofrequency catheter ablation