环肺静脉消融治疗心房颤动的有效性和安全性:一项多中心临床注册研究

目的 评估环肺静脉消融治疗心房颤动(房颤)的有效性和安全性,分析房颤消融后复发的危险因素.方法 通过多中心临床注册研究的方式收集全国2006年1月至2006年12月期间行环肺静脉消融治疗房颤的1136例有效病例资料,分析环肺静脉消融治疗房颤的成功率、复发率和并发症发生情况.将临床和超声影像学指标作为待选变量,对消融后房颤复发的危险因素进行研究.结果 在(9.1±3.8)个月的随访期间,环肺静脉消融治疗房颤的成功率为75%,复发率为25%.阵发性房颤成功率(76.7%)明显高于持续性房颤成功率(68.1%)和永久性房颤成功率(54.2%,P＜0.05).消融总的并发症发生率为2.5%,其中心脏压塞11例(1.0%),皮下血肿8例(0.7%),感染5例(0.4%),血栓栓塞2例(0.2%),脑卒中2例(0.2%).与复发相关的危险因素是非阵发性房颤(P＜0.01)和左心房内径增大(P＜0.05).结论 环肺静脉消融治疗房颤具有较好的有效性和安全性.

Efficacy and safety of circumferential pulmonary vein ablation of atrial fibrillation: a multicenter clinical registration study

Objective The purpose of this registry study was to investigate the saflety and efficacy,and to identify possible predicmrs of recurrence of circumferential pulmonary vein ablation(CPVA)in patients with atrial fibrillation(AF).Methods Data from 1136 patients who underwent CPVA for AF from January 2006 to December 2006 in multiple hospitals were collected.The SUCCESS rate,recurrence rate and complications were analyzed.The relationship between the recurrent AF and clinical and echocardiographic variables Wflg investiga-ted.Results After a mean follow-up of(9.1±3.8)months,the success rate and recurrence rate was 75% and 25%.respectively.The success rate of paroxysmal AF(76.7%)was significantly higher than that of per-sistent AF(68.1%)and permanent AF(54.2%,P＜0.05).Complications occurred in 28 patients(2.5%),including pericardial tamponade 11 cases(1.0%),ecchymoma 8 cages(0.7%),infection 5 cases(0.4%), embolism 2 casea(0.2%)and stroke 2 cases(0.2%).Non-paroxysmal AF andleft atrium dimension(LAD) enlargement were risk factors of recurrent AF(P＜0.01 and P＜0.05,respectively).Conclusion CPVA is a safe and effective treatment for AF.