摘要
背景既往射频消融术治疗心房颤动主要根据术者的临床经验进行操作,而量化消融评价指标的出现可以缩短手术时间,提高手术成功率,减少并发症的发生。目的研究消融指数(AI)指导下射频消融术治疗心房颤动的有效性及安全性,以期为AI指导下射频消融术治疗心房颤动提供临床依据。方法选取2018年10月-2019年5月于中国人民解放军白求恩国际和平医院心血管内科行射频消融术的心房颤动患者69例为研究对象。采用随机数字表法将患者分为试验组(41例,在AI指导下行射频消融术)和对照组(28例,在接触压力参数指导下行射频消融术)。比较两组一般资料、手术相关指标〔包括手术总时间、X线透视时间、肺静脉隔离(PVI)单圈隔离情况、电复律使用情况、手术相关并发症发生情况〕、近期(术后3个月)复发情况,并记录试验组术中实际使用的AI。结果试验组手术总时间、X线透视时间短于对照组(P<0.05);两组PVI单圈隔离率、电复律使用率、手术相关并发症发生率比较,差异无统计学意义(P>0.05)。两组近期复发率比较,差异无统计学意义(P>0.05)。试验组术中实际使用的AI,左心房后壁多为370,功率为30 W;环肺底部多为370,功率为30 W;左心房前壁多为420,功率为35 W;左心房顶部多为390~420,功率为30 W;脊部多为420,功率为30 W。结论AI指导下射频消融术治疗心房颤动缩短了手术总时间和X线透视时间,且不增加PVI单圈隔离率、电复律使用率、手术相关并发症发生率、近期复发率,有益于术者安全、高效地完成手术。
Background Radiofrequency ablation of atrial fibrillation is performed mainly according to the clinical experience of the operator previously.However,the successful rate is increasing,the procedural time and the occurrence of complications are decreasing with the emergence of quantitative index of ablation.Objective To evaluate the efficacy and safety of radiofrequency ablation guided by ablation index(AI)on atrial fibrillation,in order to provide clinical evidence for AIguided radiofrequency ablation in the treatment of atrial fibrillation.Methods From October 2018 to May 2019,69 patients with atrial fibrillation who underwent radiofrequency ablation in the Department of Cardiology of Bethune International Peace Hospital were selected.Patients were randomly divided into experimental group(n=41,patients who underwent AI-guided radiofrequency ablation)and control group〔n=28,patients who underwent contact force(CF)-guided radiofrequency ablation〕.The baseline characteristics,procedure related indicators(including total procedure time,X-ray fluoroscopy time,single loop rate of PVI,use of electrical cardioversion,complications associated with the procedure)and recent recurrence(3 months after procedure)were compared between the two groups.The AI values used in the experiment group were also recorded.Results The total procedure time and X-ray fluoroscopy time of the experimental group were shorter than those of the control group(P<0.05).There was no significant difference in single loop rate of PVI,electrical cardioversion rate,and incidence of complications associated with the procedure between the two groups(P>0.05).The recent recurrence rate was similar between the two groups(P>0.05).In the experimental group,most of the AI used in the procedure was 370 in the posterior wall of left atrium,30 W in power;370 in the bottom of annulus lung,30 W in power;420 in the anterior wall of left atrium,35 W in power;390-420 in the top of left atrium,30 W in power;420 in the ridge,30 W in power.Conclusion AI-guided radiofrequency ablation can shorten the total procedure time and X-ray fluoroscopy time.While single loop rate of PVI,electrical cardioversion rate,complications associated with the procedure and recent recurrence rate were not affected.Therefore,it is beneficial to the surgeon to complete the procedure safely and efficiently.
作者
马彦卓
侯广道
汝磊生
唐丽娜
齐书英
MA Yanzhuo;HOU Guangdao;RU Leisheng;TANG Lina;QI Shuying(Department of Cardiology,Bethune International Peace Hospital,Shijiazhuang 050000,China)
出处
《实用心脑肺血管病杂志》
2020年第5期7-11,共5页
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
基金
河北省医学科学研究重点课题(20150372)。
关键词
心房颤动
消融技术
肺静脉隔离
消融指数
接触压力参数
治疗结果
Atrial fibrillation
Ablation techniques
Pulmonary vein isolation
Ablation index
Contact force
Treatment outcome
