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目的探讨持续性心房颤动(简称房颤)患者环肺静脉电隔离(CPVI)术后再次行心房高密度基质标测,存在低电压区和/或疤痕区域的患者进一步行相关基质改良的价值。方法选取2013年5月至2015年5月在本中心首次接受三维标测系统指导下CPVI术及术后行心房高密度基质标测的129例持续性房颤患者。35例经高密度基质标测证实左房无低电压区和/或疤痕区,作为A组。94例患者左房存在低电压区和/或疤痕区,选取其中29例不进行相关基质改良,作为B组;选取34例针对低电压区和/或疤痕区再次进行基质改良,作为C组;另31例仅针对房顶及二尖瓣峡部进一步行线性消融,作为D组。比较各组射频消融手术成功率的差异性。结果 A、B、C、D组患者随访1年的单次手术成功率分别为65.7%、31%、64.7%、58.1%,4组患者单次手术成功率比较差异有显著性(P<0.05);A、C、D组的成功率明显高于B组(P<0.01或0.05)。结论以心房高密度标测为指导的基质改良有可能进一步提高持续性房颤射频消融的手术成功率。
Objective To investigate the value of atrial fibrillation in patients undergoing atrial fibrillation (CP) with atrial fibrillation followed by high-density atrial anomalies and low-voltage and / or scarring. Methods From May 2013 to May 2015, 129 consecutive patients with atrial fibrillation undergoing CPVI and postoperative atrial high-density matrix were selected under the guidance of three-dimensional mapping system. 35 cases confirmed by high-density matrix mapping left atrium without low voltage area and / or scar area, as A group. Ninety-four patients with left atria were found to have low-voltage and / or scarring. Twenty-nine of them were selected as group B without improvement of related stroma. Forty-three patients were re-treated with low-voltage area and / The other 31 cases only directed to the roof and mitral valve islet further linear ablation, as the D group. The radiofrequency ablation success rates were compared between groups. Results The successful rates of single operation were 65.7%, 31%, 64.7% and 58.1% respectively in the groups A, B, C and D after one year follow-up. The success rates of single operation in the four groups were significantly different (P <0.05 ); The success rates of group A, C, D were significantly higher than those of group B (P <0.01 or 0.05). Conclusions Atrial matrix-based atrial densitometry as a guideline may further improve the success rate of radiofrequency ablation in patients with persistent atrial fibrillation.