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目的:探讨冲洗射频消融术治疗心房颤动在瓣膜手术中的应用。方法:应用美敦力Cardioblate冲洗射频消融系统(单极40例,双极17例),按照Cox迷宫3手术路径进行射频消融,同期行瓣膜替换治疗57例风湿性心脏瓣膜病合并心房颤动患者。结果:术后心房颤动均消失,整个消融过程耗时平均22min,1例因肾功能衰竭术后第7天死亡,出院时48例维持窦性心律(84%),7例仍为房颤,1例为结性心律。结论:冲洗射频消融改良迷宫术操作简便、安全、有效,单双极射频消融效果均取得满意结果,但远期效果尚待进一步研究。
Objective: To investigate the application of irrigation radiofrequency ablation in the treatment of atrial fibrillation. Methods: Radiofrequency catheter ablation was performed using Medtronic Cardioblate (40 in unipolar and 17 in bipolar). The patients underwent radiofrequency ablation according to the Cox maze 3 pathology. In the same period, 57 patients with rheumatic valvular heart disease complicated with atrial fibrillation were treated with valve replacement. Results: Atrial fibrillation disappeared after operation. The entire ablation process took an average of 22 minutes. One case died of renal failure on the 7th day after operation. 48 cases maintained sinus rhythm (84%) at discharge, 7 cases remained atrial fibrillation, One case was a nodal rhythm. Conclusion: The improved labyrinthine radiofrequency catheter ablation is easy, safe and effective, and both single-dipole and radiofrequency ablation results are satisfactory. However, the long-term effect remains to be further studied.