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目的探讨经导管消融治疗并发于原发性甲状腺机能亢进(简称甲亢)的心房颤动(简称房颤)的效果。方法18例甲亢并发房颤患者,均经抗甲亢治疗控制甲状腺激素水平在正常范围内3个月以上,仍伴有发作频繁、症状严重,经抗心律失常药物治疗无效的阵发性或持续性房颤。在三维电解剖标测系统和肺静脉环状标测联合指导下行环绕两侧肺静脉的线性消融。消融终点为双侧肺静脉的电学隔离。结果18例患者术中均达到消融终点。随访12.6±6.8(4~27)个月,13例(72%)患者在不服用任何抗心律失常药物前提下无房颤发作,5例(28%)房颤复发。无任何操作相关并发症。结论对于发生于甲亢患者的房颤,三维标测系统指导下的环肺静脉线性消融术是一项可供选择的治疗措施。
Objective To investigate the effect of catheter ablation in the treatment of atrial fibrillation (Atrial Fibrillation) complicated with primary hyperthyroidism (Hyperthyroidism). Methods 18 patients with hyperthyroidism and atrial fibrillation were treated by anti-hyperthyroidism control thyroid hormone levels within the normal range of more than 3 months, still accompanied by frequent seizures, severe symptoms, anti-arrhythmic drugs ineffective paroxysmal or persistent Atrial fibrillation. In the three-dimensional electroanatomic mapping system and pulmonary vein ring mapping jointly guided downlink around the pulmonary vein on both sides of the linear ablation. The end point of ablation is the electrical isolation of the bilateral pulmonary veins. Results All 18 patients reached the end of ablation during operation. Follow-up was 12.6 ± 6.8 (4-27) months. No episodes of atrial fibrillation occurred in 13 patients (72%) taking any anti-arrhythmic drug and 5 (28%) patients relapsed. No operation-related complications. Conclusions For patients with atrial fibrillation in patients with hyperthyroidism, three-dimensional mapping system under the guidance of circumferential pulmonary vein ablation is an alternative treatment.