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目的研究导管射频消融术对特发性心房颤动(AF)患者左心功能及预后的影响。方法入选2007年10月至2009年11月在贵州省人民医院心内科成功行射频消融术后未复发的特发性AF患者28例。包括持续性AF组(SAF)13例,阵发性AF组(PAF)15例。于术前、术后1个月、半年、1年时随访超声心动图检查,分别测量二尖瓣血流频谱、左心房射血力(LAEF)及左心室射血分数(LVEF),同时行生存质量问卷调查。结果射频消融术成功治疗AF后,3例SAF组患者二尖瓣血流频谱A峰未出现,其余A峰流速较术前明显增加(P<0.05);术后半年PAF组患者LAEF基本恢复正常(P<0.05),术后1年SAF组患者LAEF有所升高,但和术前相比差异无统计学意义(P>0.05);术后各组左心室射血分数较术前增加[SAF组(55.79±8.96)%对(48.13±5.18)%,P<0.05;PAF组(64.59±7.41)%对(51.09±5.63)%,P<0.01];各组总生存质量评分显著改善(P<0.05);PAF患者左心功能较SAF组恢复更为明显(P<0.05)。结论射频消融术后PAF患者左心功能恢复较SAF更加显著及迅速,预后更好,提示SAF患者射频消融术后须长期随访及相应治疗。
Objective To investigate the effect of catheter ablation on left ventricular function and prognosis in patients with idiopathic atrial fibrillation (AF). Methods Twenty-eight patients with idiopathic AF who did not relapse after radiofrequency catheter ablation were successfully performed in Department of Cardiology, People’s Hospital of Guizhou Province from October 2007 to November 2009. Including persistent AF group (SAF) in 13 cases, paroxysmal AF group (PAF) in 15 cases. Preoperative, postoperative 1 month, 6 months, 1 year follow-up echocardiography were measured mitral flow spectrum, left atrial ejection (LAEF) and left ventricular ejection fraction (LVEF), at the same time Quality of life questionnaire. Results After radiofrequency ablation was successfully treated with AF, peak A of mitral flow spectrum did not appear in 3 SAF patients, and the peak flow velocity of other peak A was significantly increased (P <0.05). LAEF in patients with PAF returned to normal after six months (P <0.05). LAEF in SAF group increased at 1 year after operation, but there was no significant difference between before and after operation (P> 0.05); left ventricular ejection fraction increased after operation The SAQ group (55.79 ± 8.96)% vs (48.13 ± 5.18)%, P <0.05; PAF group (64.59 ± 7.41)% vs (51.09 ± 5.63)%, P <0.01] P <0.05). The recovery of left ventricular function in patients with PAF was more obvious than that in SAF patients (P <0.05). Conclusions The recovery of left ventricular function in patients with PAF after radiofrequency catheter ablation is more significant and rapid than that of SAF, and the prognosis is better. It suggests that long-term follow-up and corresponding treatment of patients with SAF after radiofrequency ablation should be performed.