射频导管消融电学隔离心脏大静脉治疗阵发性心房颤动的临床应用

来源 :中华心律失常学杂志 | 被引量 : 0次 | 上传用户:puppy_tang
下载到本地 , 更方便阅读
声明 : 本文档内容版权归属内容提供方 , 如果您对本文有版权争议 , 可与客服联系进行内容授权或下架
论文部分内容阅读
目的评价射频导管消融电学隔离心脏大静脉预防阵发性心房颤动(房颤)发作的疗效。方法83例患者,男性58例、女性25例,年龄15~76平均(605±185)岁,有阵发性房颤病史2~15年,曾服数种抗心律失常药物疗效不佳。41例患者合并有高血压病,所有患者均无明显器质性心脏病改变。常规行心脏大静脉造影,测量靶静脉直径,将10极肺静脉环状标测导管(Lasso导管)放置在靶静脉开口内05cm处,以Lasso导管为指导,把温控大头电极导管放置于靶静脉开口处行电学隔离。结果83例患者共电学隔离大静脉343条。包括左上肺静脉(LSPV)83条,右上肺静脉(RSPV)83条,左下肺静脉(LIPV)82条,右下肺静脉(RIPV)42条,上腔静脉(SVC)53条,其中2例LSPV与LIPV共同开口。每条肺静脉行1~4段消融(平均每条消融25段),即刻电学隔离成功大静脉337条。随访2~31个月,其中50例停服抗心律失常药物后无房颤发生,13例患者房颤发作明显减少,20例患者房颤发作消融前后无明显变化。并发症有2例术中出现左侧大量胸腔积血,1例心肺复苏5天后出现脑死亡。发现肺静脉狭窄21例,其中轻度狭窄15例,重度狭窄6例,无肺静脉闭塞。结论(1)成功的心脏大静脉电学隔离治疗阵发性房颤的总有效率达到75%左右;(2)由于很难确定靶肺静脉,成功电学隔离各心脏大静脉有可能提高治愈率;(3)此 Objective To evaluate the curative effect of radiofrequency catheter ablation of electrical isolation of cardiac vein to prevent the onset of paroxysmal atrial fibrillation (AF). Methods 83 patients, 58 males and 25 females, aged 15 to 76 (605 ± 185) years of age, with a history of paroxysmal atrial fibrillation 2 to 15 years, had taken several anti-arrhythmic drugs ineffective. 41 patients with hypertension, all patients had no significant organic heart disease changes. Conventional cardiac venous angiography, measuring the diameter of the target vein, the 10-pole pulmonary vein mapping catheter (Lasso catheter) placed in the venous opening 05cm Department, with Lasso catheter as the guide, the temperature control bulk lead placed in the target vein The openings are electrically isolated. Results 83 patients were electrically isolated 343 large veins. Including 83 left superior pulmonary vein (LSPV), 83 right superior pulmonary vein (RSPV), 82 left lower pulmonary vein (LIPV), 42 right lower pulmonary vein (RIPV) and 53 superior vena cava (SVC) Open. Each pulmonary vein ablation 1 to 4 ablation (an average of 25 ablation), the immediate success of electrical isolation of large vein 337. All the patients were followed up for 2 ~ 31 months. Fifty patients stopped atrial fibrillation after taking antiarrhythmic drugs. The incidence of atrial fibrillation was significantly reduced in 13 patients. There was no significant change in 20 patients before and after atrial fibrillation. There were two cases of complications in the left side of a large number of pleural hemorrhage occurred, 1 case of cardiopulmonary resuscitation brain death occurred 5 days later. 21 cases of pulmonary vein stenosis were found, of which 15 cases had mild stenosis, 6 cases had severe stenosis, and no pulmonary vein occlusion. Conclusions (1) The total effective rate of successful cardiac venous isolation in treating paroxysmal atrial fibrillation is about 75%. (2) The successful isolation of cardiac ventricles by electrical isolation may increase the cure rate due to the difficulty of identifying target pulmonary veins. 3) this
其他文献
目的 探讨洛伐他汀和氟伐他汀对急性冠脉综合征患者血清高敏C 反应蛋白 (hs CRP)及血脂水平的影响。方法  78例急性冠脉综合征患者随机单盲分为 3组 ,其中对照组 (A组 ) 18
目的分析和探讨心脏罕少疾病影像学诊断.方法选择资料完整的21例为研究对象,回顾和分析其临床及影像学资料,比较各种影像学检查的价值.结果男13例,女8例.11例具有影像学的特
17世纪末期,欧洲的一个小城镇曾经发生了一件奇怪的事情:在一个雷电的夜晚.一个落地雷闪进了一个鞋铺.第二天早上修鞋师傅发现掌鞋用的铁砧子沾满了铁钉.活像一个“铁刺猬”(如图1
胰岛素抵抗是Ⅱ型糖尿病的重要病因和显著特征,不仅是Ⅱ型糖尿病的重要病理基础,还与相关的并发症有密切关系,所以针对胰岛素抵抗的治疗成为治疗糖尿病的关键.本文将近年来采
观察妙奥春颗粒对老年骨老化的防治作用.将门诊所选60例患者随机分为治疗组30例,对照组30例.治疗组给予妙奥春颗粒,对照组给予维生素E,以3个月为1个疗程,观察其疗效.临床研究
目的 探讨MMP9和CD44V6在大肠癌中的表达与大肠腺癌术后是否复发的关系。方法 应用免疫组化技术 ,检测 12 8例大肠腺癌组织中MMP9和CD44V6的表达。结果  12 8例大肠腺癌中
在现代医院管理中,要创造一流的服务水平和理想的护理技能,护理管理者必须坚持以人为本,处理好人财物的关系,提高管理水平;坚持用育并举,正确处理好使用和培养的关系,提高员
目的 评价电视宫腔镜对子宫内疾病的诊断及应用价值。方法 对 816例可疑子宫内疾病病人 ,随机分为两组 :宫腔镜组 (观察组 ) 4 16例 ,单纯诊刮组 4 0 0例作为对照 (对照组
Objective:To explore the causes of the formation of traumatic carotid-cavernous fistulas and the therapeutic effect of detachable balloon and/or coil embolizati
从分离自香港红树林的两株南海海洋真菌(#2526和#1850)的代谢产物中首次同时分离到3个(口山)酮类天然产物,通过波谱技术分别鉴定为柄曲霉素(A)、二氢柄曲霉素(B)和3,8-二羟基