摘要
目的 比较普通射频消融导管、盐水灌注射频消融导管、超声球囊导管电学隔离肺静脉的即刻成功率、复发率和并发症。方法 自 1998年 8月至 2 0 0 3年 12月共对 2 0 6例心房颤动 (房颤 )患者进行了导管消融术 ,肺静脉隔离术 15 3例 ,其中在肺静脉电学隔离 30min后对左心房 肺静脉电学传导性进行再次评价者 79例 ,根据使用不同的消融导管分为 :A组 (n =2 3) ,普通消融导管组 ;B组 (n=35 ) ,盐水灌注消融导管组 ;C组 (n =2 1) ,超声球囊导管组。结果 A、B和C组肺静脉电学隔离成功率分别为 92 5 % (6 2 / 6 7)、 97 1% (135 / 139)和 6 8 3% (4 1/ 6 0 ) ,A组和B组间差异无显著性 (P =0 15 4 ) ,但均显著高于C组 (P <0 0 0 0 1)。 30min后 (即刻 )左心房 肺静脉电学传导复发率 :A组、B组和C组肺静脉电学隔离后即刻复发率分别为 71 0 % (4 4 / 6 2 )、 6 5 2 % (88/ 135 )和 2 4 4 % (10 / 4 1) ,A组和B组间差异无显著性 (P =0 5 14 ) ,但均显著高于C组 (P <0 0 0 0 1)。消融直接导致的并发症 :A组肺静脉狭窄 1例 (狭窄程度 >5 0 % ) ,B、C组无肺静脉狭窄并发症 ;C组膈神经麻痹 1例 ,因消融右上肺静脉所导致。结论 射频导管尤其是盐水灌注射频导管电学隔离肺静脉的即刻成功率高 ,但是即刻复发率也?
Objective To investigate the differences between conventional ablation catheter,saline-irrigated ablation catheter,and ultrasound balloon catheter for isolation of pulmonary veins (PVs) in patients with atrial fibrillation(AF).Method Two hundred and six patients with AF underwent trans-catheter ablation treatment from Aug. 1998 to Dec. 2003.Electrical conduction through left atrium and pulmonary vein(LA-PV) was revaluated 30 minutes after electrical isolation of pulmonary veins(PVI) in 79 cases out of the 153 patients who underwent PVI,and they were divided into 3 groups according to different kinds of ablation catheter used: conventional ablation catheter for Group A (n=23);saline-irrigated ablation catheter for Group B (n=35);ultrasound catheter for Group C(n=21).Results(1)Success rates of PVI were 92.5%(62/67),97.1%(135/139)and 68.3% (41/60)for Group A,B and C respectively.No difference was seen between Group A and B (P=0.154),but they were much higher than that in Group C (P<0.0001). (2)Immediate recurrence of LA-PV conduction were 71% (44/62),65.2% (88/135),and 24.4% (10/41) for Group A,B and C,respectively. No difference between Group A and B (P=0.514),but they were also significantly higher than that in Group C (P<0.0001).(3) Complications: PV stenosis developed in 1 patient in Group A,phrenic nerve paralysis was observed in 1 patient in group C due to left superior PV ablation with ultrasonic energy.Conclusions Success rate of PVI with both conventional radiofrequency catheter and saline-irrigated one was high,but immediate recurrence rate was also high,PV stenosis could be seen with these catheters. On the contrary,success rate was low with ultrasound balloon catheter ablation,but immediate recurrence rate was also low and without PV stenosis.
出处
《中华心律失常学杂志》
2004年第3期158-161,共4页
Chinese Journal of Cardiac Arrhythmias
关键词
超声能量
射频能量
心房颤动
肺静脉
消融
Ultrasound energy
Radiofrequency energy
Atrial fibrillation
Pulmonary vein
Ablation
