肺静脉线-段-点联合消融治疗心房纤颤的临床观察

目的采用左房环状线性(线)消融、肺静脉口节段性(段)电隔离术加局灶性(点)消融法(简称线-段-点法)治疗心房纤颤(房颤),并研究该方法的有效性和安全性。方法采用8mm温控消融导管分别在左房环状线性消融左右侧上下肺静脉口周围,肺静脉口壶腹部节段性消融丛状电位,最后标测和点状消融提前的单相电位(在肺静脉内或心房内)。结果26例患者均行肺静脉开口外环状线性消融。电隔离肺静脉共89条。行点状消融共25例。26例中20例所有异常电位消失,6例肺静脉内仍有高耸的异常电位,但已达到传出阻滞。手术即刻成功率100%。随访4～8个月,24例(92%)未发作房颤;术后仍有房颤发作而服用抗心律失常药物后房颤发作明显减少者2例(8%)。未发生并发症。结论线-段-点联合消融法治疗房颤,方法简单,成功率高,并发症少。

The clinical study of atrial fibrillation radiofrequency catheter ablation by linear-segement-discrete ablation method

Objective To investigate the efficacy and safety of the method of radiofrequency catheter ablation by circumferential atrial ablation?segmental electrical isolation of pulmonary veins ostium(PVs) and discrtet ablation (linear-segement-discrete) in patients with atrial fibrillation. Methods Using 8 mm tip temperature control ablation catheter to ablate PVS spike potential and early unilateral potential by local or discrete ablation in PVS or artial after isolate left and right PVs. Results Circular isolation of PV ostium were used in 26 patients. 89 PVs were targeted and local ablation were performed in 25 patients. Of 26 patients, complete segmental electrical isolation of PVs were achieved in 20, 6 had PVS spike potentials but performed exit conduction block. Successful isolation was obtained 100%. After a follow-up of 4-8 months, 24(92%) did not take place, 2 relapsed but Af decreased after taking anti-arrhythmic. Conclusion The methods of radiofrequency catheter ablation of linear atrial ablation? segmental electrical isolation of pulmonary veins(PVs) and discrete ablation is easy and has higher success rate and lower complication.