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目的观察老年心房颤动(房颤)患者射频消融术后的有效性,探索房颤射频消融复发的危险因素和独立预测因子。方法选取2009年3月~2013年5月在我院心内科首次行房颤射频消融术的老年患者91例,收集临床、电生理及随访资料,分析其长期有效性、复发心律失常类型,探索复发相关指标。结果 91例房颤患者中,单次消融后有效率为58.2%,部分复发患者进行再次射频消融后总体有效率上升为71.4%,左心房容量>40ml为房颤患者单次射频消融术后复发的独立危险因素(OR=2.569,95%CI:1.072~6.154,P=0.034)。无影响预后的严重围术期并发症。结论对于老年房颤患者,射频消融治疗具有明确疗效且安全性较好,应注意心房扩大患者射频消融治疗后存在更高的房颤复发率。
Objective To observe the effectiveness of radiofrequency ablation in elderly patients with atrial fibrillation (AF) and to explore the risk factors and independent predictors of RFA recurrence in atrial fibrillation. Methods Ninety-one elderly patients with atrial fibrillation radiofrequency ablation were selected from the Department of Cardiology of our hospital from March 2009 to May 2013. The clinical, electrophysiological and follow-up data were collected and their long-term effectiveness and type of arrhythmia were explored Relapse related indicators. Results Among 91 patients with atrial fibrillation, the effective rate after single ablation was 58.2%. The total effective rate increased to 71.4% after some radiofrequency ablation in patients with atrial fibrillation. The left atrial volume> 40ml was the recurrence after a single radiofrequency catheter ablation (OR = 2.569, 95% CI: 1.072 ~ 6.154, P = 0.034). No serious prognosis of perioperative complications. Conclusion For elderly patients with atrial fibrillation, radiofrequency ablation has a clear effect and good safety. It should be noted that there is a higher recurrence rate of AF after radiofrequency ablation in patients with atrial enlargement.