摘要
目的探讨心房颤动（房颤）患者经过房室结消融后心脏再同步治疗（CRT）的临床疗效。方法将80例在本院接受CRT的心功能不良患者按术前心律分为两组：房颤组（15例）、窦性心律组（65例），房颤组患者在CRT治疗同时行房室结消融。房室结消融和CRT术前收集患者基本信息如年龄、性别、心功能（NYHA分级）、病程、糖尿病和高血压病史、血压、心电图、超声心动图、左心室12节段达峰时间标准差（TS—SD）、室间隔一左心室后壁达峰时间差（SPMWD）、氨基末端脑钠素前体（NT—proBNP），术后收集左心室导线位置、心脏再同步治疗除颤器（CRT—D）植入的比例，以及术后药物的使用情况等，术后6—12个月随访超声心动图、心功能、6min步行试验，分析临床疗效与上述因素的关系。结果在校正左束支阻滞和左心房内径后，两组间在临床疗效方面（包括死亡率）差异无统计学意义（P〉0.05）；两组的临床有效率分别为66．7％和70．8％。结论接受房室结消融的房颤患者和窦性心律患者一样，均能够从CRT中获益。
Objective To investigate the clinical response of cardiac resynchronization therapy （CRT） and atrioventricular node （AVN） ablation in patients with heart failure and atrial fibrillation. Methods A total of 80 patients were included in the study ,65 with sinus rhythm （SR） and 15 with atrial fibrillation（AF）. Patients with atrial fibrillation were received CRT and AVN ablation. Chnical parameters （age,gender, NYHA functional class,course of disease, medical history,blood pressure,et al）,NT-proBNP,QRS duration and echocardiographic parameters were collected at baseline, CRT-D ratio, drug, NYHA functional class,6-min walk test and echocardiographic parameters at 6-12 months after CRT were collected and compared. Stepwise multivaluables regression was performed to define whether the AF is independent determinants of them. Results Apart from left bundle branch block and left atrial diameter, baseline characteristics and clinical response after 6-12 months between patients with SR or AF were comparable （P〉O. 05 ）. Stepwise multivaluables linear regression revealed that AF wasn＇ t independent determinant of the clinical response （P〉0. 05）. Conclusion The present results demonstrate a similar benefit in heart function in both groups.
出处
《中华心律失常学杂志》
2011年第4期255-258,共4页
Chinese Journal of Cardiac Arrhythmias
基金
复旦青年基金（C-118）
关键词
心脏再同步治疗
心房颤动
窦性心律
Cardiac resynchronizafion therapy
Atrial fibrillation
Sinus rhythm
