射频迷宫术治疗心房颤动

为探讨射频迷宫术治疗心房颤动（简称房颤）的效果，比较１８例二尖瓣置换术中加做迷宫术（治疗组）和１８例单纯二尖瓣置换术（对照组）的慢性房颤治疗结果。治疗组前２例采用切割冷冻法完成迷宫术，后１６例采用改良的射频法。其中１６例（８８．９％）于术后当日至２２日转为窦性心律。切割冷冻法有１例因术后出血给予大量输血引起急性肾功能衰竭而死亡，余未见明显并发症。随访２～１２个月未见房颤复发。对照组中５例曾于术后恢复短暂窦性心律，但出院时又转为房颤。结果表明迷宫术能有效地治愈慢性房颤，改良的射频法比切割冷冻法操作简单，无出血并发症，心房肌损伤小。提示心房的大小、ｆ波的粗细、心功能的好坏等是影响迷宫术成功的因素

Surgical Treatment of Atrial Fibrillation With Maze Procedure by Radiofrequency Ablation

The results of surgical treatment of atrial fibrillation by maze procedure in 18 patients(treatment group) were compared with those of no maze procedure in 18 pateints(control group)undergoing the mitral valve replacement operation only.The maze procedure was performed by surgical incision and freezing in the first two patients and by radiofrequency ablation in the other 16 patients in the treatment group.Sinus rhythm was recovered from atrial fibrillation during 1～22 days after operation in 16 patients(88.9%) in the treatment group.One patient died by acute renal failure due to transfusion of much blood for bleeding after operation,others had no serious complications.Atrial fibrillation did not recur in any patient with sinus rhythm discharged from hospital during a follow up of 2～12 months.In the control group all patients were discharged in atrial fibrillation even though 5 of them had ever transited sinus rhythm after operation.The unsuccessful two cases showed that the enlargement of atrium,small f waves and heart failure were influential in the results of the maze procedure.The results show that maze procedure can cure chronic atrial fibrillation,and compared with surgical incision and freezing,radiofrequency ablation has a simple operation,no bleeding complication and less damage of atrial muscles.