阵发性心房颤动射频消融治疗60例临床分析

目的分析导管消融治疗阵发性心房颤动的有效性和安全性．方法选择2007年7月至2010年8月阵发性心房颤动患者60例，30例愿意接受Lasso导管及Carto标测指导下的环肺静脉线性消融手术治疗（研究组），30例接受抗心律失常药物治疗（对照组）．结果随访3～36个月，研究组3例复发，1次成功有效率为27／30（90％），并发症4例，其中2例迷走反射、1例股静脉血肿、1例术后消化道出血；对照组中11例有效（36．7％），并发症10例，4例脑栓塞（其中1例死亡，3例偏瘫），1例脑出血导致偏瘫，2例皮下出血，1例消化道出血，2例由于服用胺碘酮使甲功异常．严重并发症8例（26．6％）．结论Lasso导管及Carto标测指导下的环肺静脉线性消融手术与药物组比较疗效高，安全性好．

Clinical Research of Catheter Ablation for 60 Patients with Paroxysmal Atrial Fibrillation

Objective To investigate the effectiveness and safety of catheter ablation in the treatment of paroxysmal atrial fibrillation. Methods A total of 60 patients with paroxysmal atrial fibrillation during the period from July 2007 to August 2010 were selected, including 30 cases with circumferential pulmonary vein ablation guided by single Lasso and Carto technique （study group） , 30 cases with antiarrhythmic drugs （control group）. Results During the 3 - 36 months of follow up, in study group, atrial fibrillation recurred in 3 cases, the first clinic success rate was 90%. Complications occurred in 4 cases, including vagal reflex in 2 cases, femoral vein hematoma in 1 case and gastrointestinal bleeding in 1 case. In control group, the effective rate was 36.7%, complications occurred in 10 cases, including cerebral infarction in 4 cases （ 1 case of death, and 3 cases of hemiplegia） , hemiplegia caused by cerebral hemorrhage in 1 case, subcutaneous hemorrhage in 2 cases and gastrointestinal bleeding in 1 case, abnormal thyroid function because of amiodarone in 2 cases. In all, serious complications occurred in 8 cases （26.6%）. Conclusion Circumferential pulmonary vein ablation guided by single Lasso and Carto technique is more effective and safer than drug treatment.