摘要
目的 对经球囊超声消融肺静脉治疗阵发性心房颤动的效果和安全性进行临床评价。方法 阵发性心房颤动患者 4 7例 ,症状明显且抗心律失常药物治疗无效。经球囊超声消融左上肺静脉、右上肺静脉和左下肺静脉的开口 ,消融终点为肺静脉电学隔离。结果 总计消融了 137支肺静脉 ,肺静脉电学隔离 95支 (6 9 3% )。 4 4例患者的随访时间为 3～ 19(11 7± 5 1)个月 ,其中 18例(4 0 9% )患者可以无需药物而维持窦性心律。并发症包括 2例右侧膈神经麻痹、4例一过性心电图下壁导联ST段抬高和 2例严重迷走神经反射 ,无肺静脉狭窄。结论 现阶段阵发性心房颤动肺静脉超声球囊消融治疗的临床疗效和安全性可以接受。进一步改进球囊设计和以高温度 (6 0～ 6 5℃ )在肺静脉开口部消融 ,有助于提高成功率 ,减少并发症。
Objective To evaluate the efficacy and safety of ultrasound balloon ablation of pulmonary veins for patients with paroxysmal atrial fibrillation (PAF).Methods Circumferential ultrasound ablation of both upper pulmonary veins (PVs) and left inferior PV was performed in 47 patients with frequent symptomatic and drug refractory PAF.The procedural endpoint was PVs isolation.Results A total of 137 PVs were ablated, and 95 of them achieved the procedural endpoint.After a mean follow-up of 3-19 (11.7±5.1) months in 44 patients, PAF was completely eliminated in 18 patients (40.9%) without antiarrhythmic drug .Complications included right phrenic nerve paralysis in 2 patients,transient ST segmental elevation in inferior leads in 4 and severe vagus reflex in 2.No evidence of narrowing of PVs was seen with repeat venography after ablation.Conclusions Ultrasound balloon ablation system can isolate multiple PVs with an acceptable results.Developing special design of ultrasound balloon catheter and ultrasound energy delivering system at the PVs ostium with a high temperature ( 60-65 ℃) may be important to maximize success rate and reduce the complications.
出处
《中华心血管病杂志》
CAS
CSCD
北大核心
2003年第7期487-490,共4页
Chinese Journal of Cardiology
