30例房颤射频消融术的临床研究

目的探讨导管射频消融术治疗房颤的临床效果。方法回顾性分析2010年11月-2013年1月我院应用导管射频消融术治疗30例房颤患者的临床资料。房颤类型：阵发性心房颤动26例,持续性/长时间持续性心房颤动4例。结果本组共行40次消融术,30例患者术中均达到消融终点,平均能量25 W。30例房颤患者消融术全部成功。仅环形隔离右上下肺静脉者1例,同时环形隔离左、右上下肺静脉者12例。随访期间所有患者均未发生肺静脉狭窄、心肌穿孔、血气胸、心脏停搏和食管穿孔等并发症。3例房颤患者术中发生迷走反射,注射阿托品后恢复正常。其中26例阵发性房颤患者消融术中转为窦性心律16例,所有患者术后3个月停用胺碘酮或心律平等抗心律失常药物。结论经导管射频消融术治疗房颤可以降低心力衰竭和血栓栓塞等并发症的发生率,具有微创、时间短、手术效果好等优点,值得临床推广和应用。

Clinical study of 30 cases of atrial fibrillation ablation

Objective To investigate the clinical therapeutic effect of radiofrequency catheter ablation in treatment of atrial fibrillation. Methods The clinical data of 30 cases of patients with atrial fibrillation that had application of radiofrequency catheter ablation from November 2010 to January 2013 in our hospital were analyzed. Type of atrial fibrillation： 26 patients with paroxysmal atrial fibrillation, 4 patients with persistent atrial fibrillation. Results There were40 times of ablation, 30 patients reached the endpoint of ablation, average power of 25 W. Atrial fibrillation ablation in30 patients were all successful, 1 cases only annular isolated right inferior pulmonary vein, and both of right and left inferior pulmonary vein isolation ring in 12 cases. In the follow-up period, there were no cases of pulmonary vein stenosis,cardiac perforation, pneumothorax, cardiac arrest and esophageal perforation. Vagal reflex occurred in 3 cases of atrial fibrillation patients, atropine injection after the return to normal. Among the 26 cases of patients with paroxysmal atrial fibrillation ablation conversion to sinus rhythm in 16 cases, all patients after 3 months of stopping amiodarone and propafenone antiarrhythmic drugs. Conclusion Transcatheter radiofrequency ablation of atrial fibrillation can reduce heart failure and thrombosis and other complications, minimally invasive, and it has advantages of short operation time,good effect, which is worthy of promotion and application.