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目的评价环肺静脉隔离(CPVI)基础上采用心房碎裂电位(CFAEs)指导的线性消融进行心房基质改良的疗效。方法分析66例持续性心房颤动(简称房颤)消融病例,所有患者标测碎裂电位,行环肺静脉隔离后根据标测结果设计消融径线。明确消融术中房颤终止比例及随访疗效。结果所有入选患者CFAEs分布比例从高向低依次为:肺静脉前庭、左房间隔、顶部、前壁等,消融径线主要为顶部线、前壁线、间隔线、峡部线等。入选患者平均消融线(1.9±0.4)根。随访(16.5±3.9)个月,52例(78.8%)患者经过一次消融术未再发心律失常。14例复发,1例为典型心房扑动,10例为阵发性房颤,1例为持续房颤,2例房性心动过速。结论持续性房颤接受CPVI附加CFAEs标测后线性消融有效、安全。
Objective To evaluate the effect of atrial fibrillation based on linear ablation guided by atrial fragmentation potential (CFAEs) based on circumferential pulmonary vein isolation (CPVI). Methods 66 patients with persistent atrial fibrillation (referred to as atrial fibrillation) ablation cases, all patients labeled fragmentation potential, the line of pulmonary vein isolation after the calibration curve based on the design of ablation lines. A clear ablation termination rate of atrial fibrillation and follow-up effect. Results The distribution of CFAEs from high to low in all patients were as follows: pulmonary vestibular vestibule, left atrial septum, apical and anterior wall, and the main ablation lines were top line, anterior wall line, interval line and isthmus line. Patients were selected on average ablation line (1.9 ± 0.4) root. Follow-up (16.5 ± 3.9) months, 52 patients (78.8%) had no recurrence of arrhythmia after one ablation. Fourteen patients relapsed, one patient had a typical atrial flutter, ten patients had paroxysmal atrial fibrillation, one had persistent atrial fibrillation and two had atrial tachycardia. Conclusions Continuous ablation of atrial fibrillation after CPVI plus CFAEs mapping is effective and safe for linear ablation.