【摘要】 目的　利用美国IBI公司生产的超声消融球囊导管和超声消融发生仪治疗和随访阵发性心房颤动 9例 ,观察疗效和并发症。方法　 9例患者中男性 5例 ,女性 4例 ,平均年龄 (5 4 4± 5 2 )岁。其中 1例为轻度高血压患者 ,其余无明显器质性心血管病病史。阵发性心房颤动病史平均为 (4 3± 3 7)年。全部患者房颤发作频率在每月 3次或以上。经穿间隔卵圆窝置入左 1号Swartz鞘 ,经Swartz鞘送入头端可控大头电极分别送至不同肺静脉 ,直接用大头电极标侧肺静脉肌袖电位或换用A focus电极标侧 ,对存在肌袖电位的肺静脉行超声消融。功率一般为 35～ 4 0瓦 ,温度为 6 0℃ ,每次消融时间为 12 0秒 ,重复至肺静脉电位被隔离或消失 ,但同一肺静脉重复消融不超过 10次。结果　本组完全成功脱离药物治疗 3例 ,发作次数明显减少或少量药物能够维持不发作 2例 ,有 2例完全无效 ,另 2例需要进一步随访。结论　超声消融肺静脉电隔离治疗阵发性心房颤动 ,本组成功率和有效率超过 5 0 % ,无肺静脉狭窄等并发症。更多还原

【Abstract】 Objective To evaluate the efficacy and safety of ultrasound ablation of pulmonary veins for treatment of paroxysmal atrial fibrillation.Methods The study population consisted of 9 patients with 5 males and 4 females enrolled consecutively,who had idiopathic paroxysmal atrial fibrillation.The ultrasound balloon was positioned through a specially sheath to the orifice of the target vein by a transseptal procedure.The balloon was inflated with contrast-mixed saline (contrast∶saline=1∶4).The volume was determined by the diameter of the target pulmonary vein. The ablation energy was usually set up at 35 to 40 watts with temperature controlled at 60 degree of centigrade.The duration of each ablation was about 120 seconds which was repeated not over 10 times.Results The average duration of the total procedure was (132±68) min for our patients.The average fluoroscopy time was (33±17) min.With a mean follow-up of (16±8) months after the procedure,AF was completely eliminated in 4 patients without antiarrhythmic drugs.The episodes of atrial fibrillation were eliminated in 2 patients with low dosage of oral amiodarone(0.1,once daily) which was ineffective before the procedure.The frequency of episodes was similar to that before the procedure in 3 patients.There are no any complications related to the procedure such as hemopericardium,air embolism and stenosis of the pulmonary veins by angiography.Conclusion The ultrasound ablation of the pulmonary veins is a new approach to treat paroxysmal atrial fibrillation.Before we determined its value,we need to do more researches with bigger sample,randomization and comparison design.更多还原