环肺静脉消融联合心房复杂碎裂电位消融治疗心房颤动的多中心临床研究

目的 观察环肺静脉消融（CPVA）联合心房复杂碎裂电位（CFAEs）消融治疗心房颤动（房颤）的有效性和安全性.方法 通过多中心临床实时注册研究的方式收集CPVA联合CFAEs消融治疗房颤的777例有效病例资料,分析其成功率和复发率,对心脏结构和功能的影响,以及并发症发生情况.结果 在平均（6.7±3.7）个月的随访期间,CPVA联合CFAEs消融治疗房颤的成功率为81.2%,复发率为18.8%.阵发性房颤成功率为88%,持续性房颤成功率为79.5%.消融术成功患者左心房内径（LAD）、左心室舒张末期内径（LVEDD）明显减小,左心室射血分数（LVEF）显著升高,P＜0.05.消融总的并发症发生率为0.9%,其中穿刺部位血肿4例,动静脉瘘2例,心脏压塞1例.结论 CPVA联合CFAEs消融治疗房颤安全、有效,对于持续性房颤,其优势尤为明显.

Efficacy and safety of circumferential pulmonary vein ablation combined complex fractionated atrial electrograms ablation for atrial fibrillation

Objective The purpose of the present study was to investigate the safety and efficacy of circumferential pulmonary vein ablation (CPVA)combined complex fractionated atrial electrograms (CFAEs)ablation for atrial fibrillation (AF), Methods Data from 777 patients who were underwent CPVA combined CFAEs ablation in multiple hospitals were collected, success rate, recurrence rate and complications were analyzed. The effect of ablation on cardiac structure and function was investigated. Results During a mean followup of(6. 3 ±3.7)months,the success rate and recurrence rate was 81.2% and 18.8% ,respectively. The success rate for paroxysmal AF and persistent AF was 88% and 79.5%, respectively. In patients with successful ablation, the left atrium dimension(LAD) and left ventricular end-diastolic dimension(LVEDD) remarkably reduced, the left ventricular ejection fraction(LVEF) was significantly increased compared with pre-operation, P ＜0. 05. Complications occurred in 7 patients(0. 9% ), including ecchymoma 4 cases,arteriovenous fistula 2 cases and pericardial tamponade 1 case. Conclusion CPVA combined CFAEs ablation is a safe and effective treatment for AF, especially for persistent AF.