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目的:观察导管射频消融(RFCA)治疗阵发性心房颤动(PAF)伴快-慢综合征(TBS)的疗效。方法:回顾性分析行RFCA治疗的PAF患者118例,依据术前24h动态心电图(Holter)结果分为3组:PAF伴TBS为第1组(16例);PAF伴窦房结功能不良(SND)但不伴TBS为第2组(12例);单纯PAF为第3组(90例)。比较术后各组的房颤(AF)复发率、起搏器(PM)植入率、术前及术后3个月的Holter中的最长RR间期(MRRI)值。结果:平均随访12个月,第1组的AF复发率和PM植入率与第3组无差异(P>0.05);第2组在AF复发率和PM植入率上均显著高于第1组(P<0.05)和第3组(P<0.05)。第1组术前的MRRI(MRRI0)显著高于第2、3组(P<0.05);第1组术后3个月的MRRI(MRRI3)与第3组相比无统计学差异(P>0.05)。结论:PAF伴TBS患者,无论是否合并SND,均可选择行RFCA;而PAF伴SND,但不伴TBS的患者,应首选PM植入加药物治疗。
Objective: To observe the curative effect of radiofrequency catheter ablation (RFCA) on paroxysmal atrial fibrillation (PAF) with rapid-slow syndrome (TBS). Methods: A retrospective analysis of 118 RFCA-treated patients with PAF was performed and divided into 3 groups based on Holter results before surgery: PAF with TBS in group 1 (16 cases); PAF with sinus node dysfunction (SND ) But not with TBS as Group 2 (12 patients); simple PAF as Group 3 (90 patients). The recurrence rate of atrial fibrillation (AF), implantation rate of pacemaker (PM), and the longest RR interval (MRRI) in Holter at 3 months after operation were compared between the two groups. Results: After a mean follow-up of 12 months, the AF recurrence rate and PM implantation rate in group 1 were not significantly different from those in group 3 (P> 0.05). The AF recurrence rate and PM implantation rate in group 2 were significantly higher than those in group 3 1 group (P <0.05) and group 3 (P <0.05). The preoperative MRRI (MRRI0) in group 1 was significantly higher than those in group 2 and 3 (P <0.05). There was no significant difference in MRRI (MRRI3) between group 3 and group 3 after 3 months (P> 0.05). Conclusion: Patients with PAF and TBS can choose RFCA regardless of whether they are combined with SND or not. Patients with PAF with SND but without TBS should be the first choice of PM implantation and drug therapy.