摘要
目的分析阵发性房颤射频消融术后肺静脉狭窄(pulmonary vein stenosis,PVS)情况。方法选择2020年11月至2023年11月我院收治行射频消融术的阵发性房颤患者125例为对象,行射频消融术,术前术后予以左房-肺静脉CT三维解剖重建,观测术后肺静脉开口狭窄、严重程度。根据术后14 d及3个月后的随访结果评估早期与晚期复发情况。结果以右肺静脉开口异常最为常见。左上肺静脉(left superior pulmonary vein,LSPV),左下肺静脉(left inferior pulmonary vein,LIPV),右下肺静脉(right inferior pulmonary vein,RIPV)及右上肺静脉(right superior pulmonaryvein,RSPV)最大径值、最小径值、横截面积、圆度手术前后与术前相比差异有统计学意义(P<0.05),手术前后静脉指数差值相比无统计学意义(P>0.05)。125例中右肺静脉开口3支变异达26例(20.80%),左肺静脉开口3支变异达5例(4.00%),右肺静脉多支变异达5例(4.00%)。与术前相比,术后左房容积较低存在统计学差异(P<0.05)。术后随访14 d发现,早期复发房性心律失常57例(45.60%),房颤54例(43.20%),房扑6例(4.80%)。结论阵发性房颤经射频消融治疗后可诱发肺静脉轻度狭窄。
Objective To investigate the pulmonary vein stenosis in patients with paroxysmal atrial fibrillation after radiofrequency ablation.Method A total of 125 patients with paroxysmal atrial fibrillation who underwent radiofrequency ablation in the Cardiovascular Department of China Resources Wuhan Iron and Steel General Hospital from November 2020 to November 2023 were selected as the study subjects.All participants underwent radiofrequency ablation,and left atrium pulmonary vein CT three⁃dimensional anatomical reconstruction was performed before and after surgery to observe the stenosis and severity of the pulmonary vein opening after surgery.Assess early and late recurrence based on follow⁃up results 14 days and 3 months after surgery.Result The most common abnormality is the right pulmonary vein opening.There were differences in the maximum diameter,minimum diameter,cross⁃sectional area,and roundness of the left superior pulmonary vein(LSPV),left inferior pulmonary vein(LIPV),right inferior pulmonary vein(RIPV),and right superior pulmonary vein(RSPV)before and after surgery compared to before surgery(P<0.05),The difference in venous index before and after surgery was not statistically significant(P>0.05).Among 125 patients,there were 26 cases(20.80%)with variations in the opening of the right pulmonary vein,5 cases(4.00%)with variations in the opening of the left pulmonary vein,and 5 cases(4.00%)with variations in multiple branches of the right pulmonary vein.Compared with preoperative,there was a statistically significant difference in postoperative left atrial volume(P<0.05).After 14 days of postoperative follow⁃up,it was found that 57 patients had early recurrent atrial arrhythmias,accounting for 45.60%of the total number,54 patients had atrial fibrillation,accounting for 43.20%,and 6 patients had atrial flutter,accounting for 4.80%.Conclusion Patients with paroxysmal atrial fibrillation can induce mild pulmonary vein stenosis after radiofrequency ablation treatment.
作者
杨涛
吕学祥
李念
王燕红
余梦琳
Yang Tao;Lv Xuexiang;Li Nian;Chen Jiajun;Wang Yanhong;Yu Menglin(Department of Cardiology,CR&WISCO General Hospital affiliated to Wuhan University of Science and Technology,Wuhan 430081,China;Wuhan University of Science and Technology of Medical Division,Wuhan 430081,China)
出处
《中华肺部疾病杂志（电子版）》
2023年第6期814-817,共4页
Chinese Journal of Lung Diseases(Electronic Edition)
关键词
阵发性房颤
射频消融术
肺静脉狭窄
复发率
Paroxysmal atrial fibrillation
Radiofrequency ablation
Pulmonary vein stenosis
Recurrence rate
