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目的 :探讨房间隔缺损(atrial septal defect,ASD)并发的心房颤动(atrial fibrillation,AF)的临床特点和治疗AF的不同方法的效果。方法:分析641例行ASD封堵术患者的AF发生率和危险因素,比较药物或者导管消融治疗AF的疗效。结果:641例ASD患者的AF发生率为4.8%,其中年龄≥40岁的AF发生率为8.4%,年龄≥60岁的患者的AF发生率高达25%。与无AF的患者相比,AF者中男性多见、年龄大、右心房平均压力高、肺动脉平均压力高、左心房内径大、左室舒张末内径大以及左室射血分数低,进一步分析发现,男性、年龄≥40岁和左房内径增大是ASD并发AF的高危因素。AF转复及维持窦性心律治疗,导管射频消融优于药物治疗。结论:ASD患者中AF的发生率高于正常人群,男性、年龄≥40岁和左房内径增大是ASD并发AF的高危因素,导管射频消融在AF转复及维持窦性心律治疗上优于药物。
Objective: To investigate the clinical features of atrial septal defect (ASD) complicated with atrial fibrillation (AF) and the effects of different methods of treating AF. Methods: The incidence and risk factors of AF in 641 patients undergoing ASD occlusion were analyzed. The efficacy of drug or catheter ablation AF was compared. Results: AF was found in 641 ASD patients with a prevalence of AF of 4.8%, with a prevalence of AF of 8.4% for those ≥40 years of age and 25% of patients ≥60 years of age. Compared with patients without AF, more common in men with AF, older, average right atrium pressure, average pulmonary hypertension, large atrial diameter, left ventricular end diastolic diameter and left ventricular ejection fraction, further analysis Found that men, age ≥ 40 years and increased left atrial diameter is a risk factor for ASD complicated with AF. AF rehabilitation and maintenance of sinus rhythm, catheter radiofrequency ablation is better than drug treatment. CONCLUSIONS: The incidence of AF in ASD patients is higher than that in normal subjects. Male, age ≥40 years and increased left atrium diameter are risk factors for AF with AF. Catheter radiofrequency catheter ablation is better than AF in the recovery of AF and maintenance of sinus rhythm drug.