摘要
目的观察心脏瓣膜病和先天性心脏病外科手术同期射频消融治疗心房颤动的有效性和安全性。方法选取2018年11月至2020年1月陕西省人民医院收治的行外科手术的心脏瓣膜病及先天性心脏病患者119例,患者术前均合并心房颤动,在外科手术同期行射频消融治疗。术后随访6个月。出院时及随访6个月时复查心电图,按照是否恢复窦性心律分为窦性心律组和心房颤动或心房扑动组。比较2组出院时及随访6个月时心脏超声指标。结果术后7~19 d出院时恢复窦性心律96例(80.7%),心房颤动21例(17.6%),心房扑动(术后9 d)2例(1.7%)。随访6个月时死亡1例,维持窦性心律者93例(78.2%)。出院时及随访6个月时,窦性心律组左心房内径均明显小于术前[(44.6±5.2)mm比(49.7±6.8)mm、(42.1±5.3)mm比(48.7±4.1)mm](均P<0.05),心房颤动或心房扑动组左心房内径与术前比较,差异均无统计学意义(均P>0.05)。结论心脏外科手术同期射频消融治疗心房颤动手术安全、效果满意。出院及随访6个月时转复窦性心律者左心房内径缩小。
Objective To observe the effect and safety of radiofrequency ablation for atrial fibrillation during surgeries for valvular diseases and congenital heart diseases.Methods From November 2018 to January2020,119 patients with valvular disease and congenital heart disease undergoing surgery in Shaanxi Provincial People’s Hospital were enrolled.All patients were complicated with atrial fibrillation before surgery and were treated with radiofrequency ablation during cardiac surgeries.After surgery,they were followed-up for 6 months.Electrocardiogram was reviewed at discharge and 6 months of follow-up,and patients were divided into sinus rhythm group and atrial fibrillation/flutter group according to sinus rhythm recovery.Cardiac ultrasound indexes at discharge and 6 months of follow-up were compared between the two groups.Results At discharge,7-19 d after surgery,96 cases(80.7%)regained sinus rhythm,21 cases(17.6%)were atrial fibrillation,and 2 cases(1.7%)were atrial flutter(9 d after surgery).At 6 months of follow-up,1 case died and 93 cases(78.2%)remained sinus rhythm.Compared with preoperation,the left atrial diameter in sinus rhythm group decreased at discharge and 6 months of follow-up[(44.6±5.2)mm vs(49.7±6.8)mm,(42.1±5.3)mm vs(48.7±4.1)mm](both P<0.05),and there were no significant differences in left atria diameter in atrial fibrillation/flutter group compared with that before surgery(both P>0.05).Conclusions Concomitant radiofrequency ablation for AF with cardiac surgery is safe and effective.Patients regained sinus rhythm have a decrease in left atrial diameter at discharge and 6 months of follow-up.
作者
魏涛
李学文
王宗超
黄晓燕
石践
宋宝国
张国安
王沙
刘强
王志坤
王侃
冯大伟
马美娟
张曦
Wei Tao;Li Xuewen;Wang Zongchao;Huang Xiaoyan;Shi Jian;Song Baoguo;Zhang Guoan;Wang Sha;Liu Qiang;Wang Zhikun;Wang Kan;Feng Dawei;Ma Meijuan;Zhang Xi(Department of Cardiac Surgery,Shaanxi Provincial People’s Hospital,Xi'an 710068,China;Key Laboratory of Infection and Immune Diseases in Shaanxi Province,Shaanxi Provincial People’s Hospital,Xi'an 710068,China;the First Department of Cardiovascular Medicine,Shaanxi Provincial People’s Hospital,Xi'an 710068,China)
出处
《中国医药》
2021年第9期1300-1303,共4页
China Medicine
基金
陕西省重点研发计划(2021SF-329)。
关键词
心脏手术
心房颤动
射频消融
左心房内径
抗凝
Cardiac surgery
Atrial fibrillation
Radiofrequency ablation
Left atrial diameter
Anticoagulation
