【摘要】 探讨房室结消融 +VVIR起搏器 (ABL +PM)治疗对永久性心房颤动 (简称房颤 )患者生活质量、心功能的改善及评估该治疗的安全性。选择 30例永久性房颤患者 ,14行例ABL +PM治疗 ,16例行药物治疗。治疗前及治疗后 12个月所有患者均做GWB和CSS生活质量评分 ,心脏超声测左室内径及射血分数值 ,活动平板测运动耐力 ,用Holter记录最快、最慢心率。并观察治疗后临床事件的发生。结果 :永久性房颤患者ABL +PM或药物治疗前、后组内比较 ,患者心室率、心功能、运动耐力及生活质量均得到改善 (P <0 .0 5 ) ;但ABL +PM组左室内径缩小 (P <0 .0 5 ) ,药物治疗组无改变 (P >0 .0 5 )。ABL +PM或药物治疗后 12个月组间比较 ,ABL +PM组心室率控制、左室内径、心功能、运动耐力及生活质量改善优于药物组 (P <0 .0 5 )。再次住院人次ABL +PM组较药物组减少 (P <0 .0 5 ) ,死亡、恶性室性心律失常和血栓栓塞事件两组无差异 (P >0 .0 5 )。结论 :ABL +PM或药物治疗均能改善永久性房颤患者心功能、运动耐力及生活质量 ,但ABL +PM优于药物治疗。ABL +PM是一种简单易行安全的治疗方法。更多还原

【Abstract】 To evaluate the beneficial effect of Atrioventricular node ablation and VVIR pacemaker(ABL+PM) on quality of life and cardiac function of patients with permanent atrial fibrillation(AF) and the safety of this therapy,30 patients with permanent AF were enrolled. 14 patients in ABL+PM group, the others in drug group. All patients were observed quality of life (GWB′scores and CSS′scores), measured left ventricular end-diastolic diameter and ejection fraction by echocardiaography and exercise duration on treadmill testing, evaluated the minimum and maximum heart rate by Holter before and after 12 months treatment. Results:The intrapatient comparison between enrollment and month 12 showed that quality of life,heart function,exercise intolerance and heart rate improved in both groups (P<0.05), but left ventricular end-diastolic diamet diameter decreased in ABL+PM group (P<0.05), didn’t in drug group (P>05). There was significant difference in quality of life,left ventricular end-diastolic diamet diameter,heart function,exercise intolerance and heart rate when ABL+PM group compared with drug group after treatment (P<0.05). Death,life-threatening ventricular arrhythmias and the events of thromboembolism were no difference between the ABL+PM group and drug group(P>0.05), while episodes of hospitalization reduced in the ABL+PM group(P<0.05). Conclusions: Quality of life and heart function of patients with permanent AF are improved by the ABL+PM or pharmacological treatment, but the ABL+PM treatment is superior to drug therapy. The ABL+PM treatment is a easily performed and safe method.更多还原