摘要
目的探讨心脏手术同期施行双极射频迷宫手术治疗心房颤动（AF）的效果及其影响因素。方法2006年7月到2008年5月在心脏手术同期施行双极射频迷宫手术141例，回顾性分析和随访，比较手术前后心律、超声心动图等各项指标及心功能变化。结果术后早期死亡6例。出院135例中，随访129例（95．56％），失访6例。随访3个月～2年，平均（16．79±7．91）个月。随访者中1例10个月死于心衰，余128例生存。心功能（NYHA）I级120例（93．75％），Ⅱ级8例（6．25％）。被随访者3个月、6个月和1年队上稳定窦性心律（sSR）分别为69．77％、72．36％和87．14％。超声显示左心房比术前明显缩小，sSR者均出现明显A峰波，左心房功能良好。结论心脏直视手术同期施行双极射频迷宫手术治疗AF安全有效。随着术后时间延长，sSR逐渐增加，AF复发率逐渐降低。老年、AF病程超过5年、左心房内径〉60mm以及中到重度的三尖瓣关闭不全是影响双极射频迷宫手术疗效的危险因素。
Objective The purpose of this study was to examine the effectiveness of bipolar radiofreqnency maze operation for atrial fibrillation （AF） undergoing cardiac surgery and its risk factors. Methods From September 2006 to May 2008, 141 patients underwent bipolar radiofrequency maze operation for AF combined with other cardiac procedures. The preoperative and postoperative indexes of electro-cardiogram, echocardiogranl and NYHA class were compared through retrospective analysis and follow-up. Results Six cases died in the early postoperative period. 129 （95.56%） were followed-up from 3 months to 2 years[ mean （43.79 ± 67.96） months] postoperatively. Of 129 cases one died from severe heart failure 10 months after operation. In the rest 128 cases, 93.75% was in cardiac function（NYHA） of grade I and 6.25% grade II. The rate of stable sinus rhythm （sSR） was 69.77%, 72.36% and 87.14% in 3-month, 6-month and over I year ＂after operation. There was a significant decrease in left atrial dimension and A peak wave appeared in all cases with sSR. Conclusion Bipolar radiofrequancy maze operation is an effective surgical option for treating AF. Age, duration of AF 〉 5 years, left atrial diameter 〉 6 cm and moderate to severe tricuspid regurgitation are the risk factors.
出处
《中华胸心血管外科杂志》
CSCD
北大核心
2009年第6期371-374,共4页
Chinese Journal of Thoracic and Cardiovascular Surgery
关键词
心房颤动
心脏外科手术
导管消融术
Atrial fibrillation Cardiac surgical procedures Radiofrequency ablation
