碎裂电位消融联合环肺静脉电隔离消融对持久性房颤患者心房功能的影响

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摘要目的探讨碎裂电位消融（CFAE）联合环肺静脉电隔离消融（CPVI）对持久性房颤患者心房功能的影响。方法选择2014年3月～2017年3月在解放军空军军医大学第二附属医院接受治疗的持久性房颤患者124例，随机数字表法分为两组，CPVI组和CPVA+CFAE组，每组62例。所有入院患者均常规检查，记录两组手术时间和X线透视时间，分析比较两组患者手术结果及房颤终止后的消融情况。术后随访12个月，采用Kaplan-meier生存曲线分析两组的窦性心律维持情况。结果 CPVI+CFAE组手术时间较CPVI组长，差异有统计学意义（P ＜ 0.05）。两组术后恢复及并发症发生情况比较，差异均有统计学意义（P ＜ 0.05）。Kaplan-meier生存曲线分析结果显示，CPVI+CFAE组较CPVI组窦性心律维持时间显著延长（P < 0.05）。结论 CPVI+CFAE联合消融治疗持久性房颤，消融术中终止或转变成功率高，可最大程度将持久性房颤消融终止或转变为房性心动过速，且维持率高。

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	白宝宝王芳芳▲ 刘雄涛曾迪廉诚李雪

关键词 ：碎裂电位消融, 环肺静脉电隔离消融, 持久性心房颤动, 房性快速性心律失常

Abstract：Objective To investigate the effect of complex fractionated atrial electrograms (CFAE) combined with circumferential pulmonary vein isolation (CPVI) on atrial function in patients with persistent atrial fibrillation. Methods A total of 124 patients with persistent atrial fibrillation having received treatment in the Second Affiliated Hospital of PLA Air Force Military Medical University from March 2014 to March 2017 were selected and they were divided into CPVI group and CPVA+CFAE group by random number table method, with 62 cases in each group. All the patients admitted to the hospital were routinely examined, and the operation time and X-ray fluoroscopy time of the two groups were recorded, and the operation results, ablation after the end of atrial fibrillation of the two groups were analyzed and compared. After 12 months′ follow-up, Kaplan-meier survival curve was used to analyze the maintenance of sinus rhythm in the two groups. Results The operation time of the CPVI+CFAE group was longer than that of the CPVI group, and the difference was statistically significant (P ＜ 0.05). The postoperative status and complications of the two groups were compared, and the differences were statistically significant (P ＜ 0.05). Kaplan-meier survival curve analysis showed that the maintenance rate of sinus rhythm in the CPVI+CFAE group was significantly higher than that in the CPVI group (P < 0.05). Conclusion CPVI+CFAE combined with ablation in the treatment of persistent atrial fibrillation has a high success rate in the termination or transformation during ablation, which can terminate or transform persistent atrial fibrillation into atrial tachycardia to a largest degree, and the maintenance rate is high.

Key words： Complex fractionated atrial electrograms Circumferential pulmonary vein isolation Persistent atrial fibrillation Atrial tachyarrhythmia

基金资助:陕西省重点研发计划项目（S2017-ZDYF-YBXM-SF-0358）。

通讯作者: ▲通讯作者

引用本文:

白宝宝王芳芳▲ 刘雄涛曾迪廉诚李雪. 碎裂电位消融联合环肺静脉电隔离消融对持久性房颤患者心房功能的影响[J]. 中国医药导报, 2018, 15(35): 54-57.
BAI Baobao WANG Fangfang▲ LIU Xiongtao ZENG Di LIAN Cheng LI Xue. Effect of complex fractionated atrial electrograms combined with circumferential pulmonary vein isolation on atrial function in patients with persistent atrial fibrillation. 中国医药导报, 2018, 15(35): 54-57.

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http://www.yiyaodaobao.com.cn/CN/ 或 http://www.yiyaodaobao.com.cn/CN/Y2018/V15/I35/54

[1] 胡大一，周自强，陈捷，等.中国心房颤动现状流行病学研究[J].中国心脏起搏与心电生理杂志，2004，18（z1）：3-6.
[2] 张琳，王娜，宫柏琪，等.脑梗死危险因素对非瓣膜性房颤患者理想INR的选择[J].脑与神经疾病杂志，2018，26（5）：288-291.
[3] 史云桃，邢玉龙，蒋廷波，等.持续性心房颤动危险因素的单中心研究[J].中华老年心脑血管病杂志，2015，17（12）：1243-1245.
[4] 付建宇，毕红英，夏云松，等.危重症患者心房颤动发生的危险因素分析[J].中华危重病急救医学，2018，30（4）：337-341.
[5] Nademanee K，McKenzie J，Kosar E，et al. A new approach for catheter ablation of atrial fibrillation：mapping of the electrophysiologic substrate [J]. J Am Coll Cardiol，2004， 43（11）：2044-2053.
[6] 张凤祥，曹克将.2010年欧洲心脏病学会心房颤动治疗指南概要[J].中华心律失常学杂志，2011，15（2）：157-159.
[7] 周自强，胡大一，陈捷，等.中国心房颤动现状的流行病学研究[J].中华内科杂志，2004，43（7）：491-494.
[8] 中华医学会心血管病分会.中国部分地区心房颤动住院病例回顾性调查[J].中华心血管病杂志，2003，31（12）：913-916.
[9] 胡大一，孙艺红，周自强，等.中国人非瓣膜性心房颤动脑卒中危险因素的病例-对照研究[J].中华内科杂志，2003，42（3）：157-161.
[10] Romero J，Gianni C，Di Biase L，et al. Catheter Ablation for Long-Standing Persistent Atrial Fibrillation [J]. Methodist Debakey Cardiovasc J，2015，11（2）：87-93.
[11] Wynn GJ，Das M，Bonnett LJ，et al. Efficacy of catheter ablation for persistent atrial fibrillation： a systematic review and meta-analysis of evidence from randomized and nonrandomized controlled trials [J]. Circ Arrhythm Electrophysiol，2014，7（5）：841-852.
[12] Jalife J. Mechanisms of persistent atrial fibrillation [J]. Curr Opin Cardiol，2014，29（1）：20-27.
[13] Ouyang ZL，Sun LP，Chi H，et al. Potential Maintenance Mechanism in Atrial Fibrillation Patients Subject to Different Treatment Procedures：A Preliminary Study Based on a Human Atrial Model [J]. Curr Med Sci，2018，38（3）：422-426.
[14] Li YG，Lee SR，Choi EK，et al. Stroke Prevention in Atrial Fibrillation：Focus on Asian Patients [J]. Korean Circ J，2018，48（8）：665-684.
[15] ■im■ek B，Altay S，?魻zbilgin N，et al. Autoimmune activation as a determinant of atrial fibrillation among Turks：A prospective evaluation [J]. Medicine ：Baltimore，2018，97（31）：e11 779.
[16] Ouyang ZL，Sun LP，Chi H，et al. Potential Maintenance Mechanism in Atrial Fibrillation Patients Subject to Different Treatment Procedures：A Preliminary Study Based on a Human Atrial Model [J]. Curr Med Sci，2018，38（3）：422-426.
[17] Kugler S，Duray G，Préda I. Novel mechanisms in the initiation and maintenance of atrial fibrillation：tailored individual treatment [J]. Orv Hetil，2018，159（28）：1135-1145.
[18] Sorgente A，Tung P，Wylie J，et al. Six year follow-up after catheter ablation of atrial fibrillation：a palliation more than a true cure [J]. Am J Cardiol，2012，109（8）：1179-1186.
[19] Verma A，Mantovan R，Macle L，et al. Substrate and Trigger Ablation for Reduction of Atrial Fibrillation（STAR AF）：a randomized，multicentre，international trial [J]. Eur Heart J，2010，31（11）：1344-1356.
[20] Wu G，Wang S，Cheng M，et al. The serum matrix metalloproteinase-9 level is an independent predictor of recurrence after ablation of persistent atrial fibrillation [J]. Clinics：Sao Paulo，2016，71（5）：251-256.
[21] Zou R，Yang M，Shi W，et al. Analysis of Genes Involved in Persistent Atrial Fibrillation：Comparisons of 'Trigger' and 'Substrate' Differences [J]. Cell Physiol Biochem，2018， 47（3）：1299-1309.