阵发性心房颤动两种射频消融术式的随机对照研究

目的:比较优化导管射频消融术(optimized radiofrequency catheter ablation,ORFCA)和环肺静脉隔离术(circumferential pulmonary vein isolation,CPVI)治疗阵发性心房纤颤(atrial fibrillation,AF)的有效性、安全性。方法:2009年3月至2010年3月于郑州市第七人民医院心内科行射频消融术(radiofrequency cather ab-lation,RFCA)治疗的阵发性AF患者随机分为CPVI组(n=40)和ORFCA术(n=44)。两组采取不同的消融术式,观察患者的左心房直径、房颤持续时间、左心室功能,成功率、并发症发生情况、消融点数、手术时间、曝光时间等数据,并比较两组之间的差别。结果:通过对CPVI组和ORFCA组基本情况的比较我们发现两组的性别组成、年龄、发作病史、左心房直径、左心室功能、应用抗心律失常药物种类方面无差别。CPVI组在消融点数、手术时间、曝光时间、成功率上均小于ORFCA组,差异有统计学意义(P<0.05)。两组在并发症发生率上无差别。结论:ORFCA术具有和CPVI术相似的安全性,和相对较高的有效性。

Comparison of two method of radiofrequency catheter ablation in the treatment of paroxysmal atrial fibrillation

Objective: We compared the efficacy and safety of optimized radiofrequency catheter ablation(ORFCA) versus circumferential pulmonary vein isolation(CPVI) in the treatment of paroxysmal(AF) atrial fibrillation.Methods: All 84 consecutive patients presenting to our institution for paroxysmal AF ablation from May 2009 to May 2010 were included in our AF ablation study.They were enrolled in CPVI group(n=40) and ORFCA group(n=44).We Compared the difference between the two groups in the left atrial dimension,course of AF,left ventricular function,successful rate,complication rate,radiofrequency ablation points,operation time,exposuretime.Results: There are no difference between two groups in gender,age,course of AF,left atrium diameter,left ventricular function and application anti-arrhythmic drugs.Exposure time,radiofrequency ablation points,operation time,exposure time and suecessful vate of CVPI group are significantly lower than those in ORFCA group.There are no difference between two groups in complation rate.Conclusion: The study demonstrates the two groups have the same safty in the treatment of paroxysmal atrial fibrillation.But ORFCA group have a higher successful rate than CPVI group.