论文部分内容阅读
目的探讨长程持续性房颤导管消融的可行性和疗效。方法 35例长程持续性房颤采用经导管射频消融治疗,术中完成环肺静脉前庭消融、左房顶部线、二尖瓣峡部消融和三尖瓣峡部消融,如未恢复窦性心律,采用直流同步电复律转复窦性心律,然后验证并实现双侧肺静脉电隔离及消融线阻滞。观察即刻消融效果及随访期间房颤复发情况。结果 2例患者消融中转复窦性心律,其余患者电复律恢复窦性心律;所有患者均实现双侧肺静脉电隔离,起搏下验证左房顶部线、二尖瓣峡部线和三尖瓣峡部线取得阻滞的比例分别为100%、88.6%和91.4%。随访期间6(17.1%)例复发。结论采用环肺静脉消融辅以线性消融治疗长程持续性房颤能够较有效地预防房颤复发,减少消融时间。
Objective To investigate the feasibility and efficacy of catheter ablation of long-term sustained atrial fibrillation. Methods 35 cases of long-term persistent atrial fibrillation were treated with catheter ablation. Intravenous pulmonary vein veins ablation, top left atrium line, mitral isthmus ablation and tricuspid isthmus ablation were completed. If sinus rhythm was not restored, Cardioversion to reverse sinus rhythm, and then verify and achieve bilateral pulmonary vein electrical isolation and ablation line block. The effect of immediate ablation and recurrence of atrial fibrillation during follow-up were observed. Results In 2 patients, the sinus rhythm was reversed during ablation, and the rest of the patients recovered sinus rhythm by electrical cardioversion. All the patients achieved bilateral pulmonary vein electrical isolation. The left atrium top line, mitral valve isthmus and tricuspid isthmus were verified by pacing The rate of line block was 100%, 88.6% and 91.4% respectively. During follow-up 6 (17.1%) cases of recurrence. Conclusions The use of circumferential pulmonary vein ablation combined with linear ablation for long-term persistent atrial fibrillation can effectively prevent atrial fibrillation recurrence and reduce the ablation time.