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目的分析心脏瓣膜病并发心房颤动(房颤)的患者外科手术同时行射频消融迷宫手术的疗效,探讨外科手术治疗瓣膜病并发房颤的临床价值。方法筛选2010年1月至2013年1月收治的瓣膜病并发房颤住院患者40例,在心内直视手术的同时行射频消融迷宫手术,观察随访术后1年患者恢复窦性心律比例。结果 40例住院手术的患者中,手术后即刻房颤全部消失,出院时窦性心律29例(72.5%),结性心律9例(22.5%),Ⅰ度房室传导阻滞1例(2.5%),Ⅲ度房室传导阻滞1例(2.5%)。随访1年后窦律27例(67.5%),结性心律3例(7.5%),心房扑动2例(5%),房颤7例(17.5%),Ⅲ度房室传导阻滞1例(2.5%),安置永久起搏器。其中29例恢复窦性心律,转复率为67.5%。结论心脏瓣膜病并发房颤的患者在心脏外科手术的同时行射频消融术,对窦律的恢复是一种安全有效的方法,手术安全性高,远期疗效确切。
Objective To analyze the curative effect of simultaneous operation of radiofrequency ablation and labyrinth surgery in patients with valvular heart disease complicated with atrial fibrillation (AF) and to investigate the clinical value of surgical treatment of valvular heart disease complicated with atrial fibrillation. Methods Forty patients with valvular heart disease and atrial fibrillation who were treated from January 2010 to January 2013 were enrolled in this study. Radiofrequency ablation maze operation was performed while the patients underwent open heart surgery. The proportion of patients with sinus rhythm was restored one year after the operation. Results Among the 40 hospitalized patients, AF disappeared immediately after operation. There were 29 cases (72.5%) of sinus rhythm, 9 cases of nodal rhythm (22.5%), 1 case of atrioventricular block %), Ⅲ degree atrioventricular block in 1 case (2.5%). One year after follow-up, there were 27 cases of sinus rhythm (67.5%), 3 cases of rhythm (7.5%), 2 cases of atrial flutter (5%), 7 cases of atrial fibrillation (17.5%), Ⅲ degree atrioventricular block Example (2.5%), placement of permanent pacemaker. Among them, 29 cases recovered sinus rhythm and the conversion rate was 67.5%. Conclusions Patients with valvular heart disease complicated with atrial fibrillation underwent radiofrequency ablation at the same time as cardiac surgery. It is a safe and effective method for the recovery of sinus rhythm, which has high operation safety and long-term curative effect.