【摘要】 目的:总结分析心房颤动(房颤)肺静脉电隔离术后早期(2周内)房颤复发者的随访结果。方法:105例房颤患者[平均年龄(55±12)岁],采用导管进行环肺静脉电隔离治疗,其中阵发性房颤78例,持续性房颤27例。实施环肺静脉电隔离共358根。结果:在术后早期随访[平均(3.9±2.6)d]中,105例患者中38例(36%)复发房颤。阵发性房颤与持续性房颤者早期房颤复发的发生率相比,差异无统计学意义(35%∶41%,P>0.05)。在后期随访[平均(208±125)d]中,67例早期未复发患者中58例(87%)、38例早期房颤复发患者中13例(34%)无房颤发生,二者成功率比较,P<0.01。结论:肺静脉电隔离术后2周内大约36%患者房颤复发,早期房颤复发患者较早期未复发者后期成功率低。更多还原

【Abstract】 Objective:To investigate the prevalence of early recurrences of atrial fibrillation(ERAf) after circumferential pulmonary vein isolation(CPVI),and to determine whether ERAf is predictive of long-term outcome after PV isolation.Method:CPVI was performed using radiofrequency energy in 105 consecutive patients with paroxysmal(78 patients) or persistent(27 patients) Af.Three to four PVs were targeted for isolation in all patients.Pulmonary vein isolation was completed in the 358 PVs that were targeted.Result:Early recurrences of Af occurred in 38 of 105 patients(36%) at a mean of(3.9±2.6) days after the procedure.The prevalence of ERAf was similar in patients with paroxysmal and persistent Af(35% and 40%,respectively,P=0.42).Beyond the first two weeks,at 208±125 days of follow-up,58 of the 67 patients without ERAf(87%) and 13 of the 39 patients with ERAf(34%) were free of recurrence Af in the absence of antiarrhythmic drug therapy(P<0.01).Conclusion:ERAf occur in approximately 36% of patients within two weeks after isolation of three to four PVs,and are associated with a lower long-term success rate than in patients without ERAf.However,approximately 34% of patients with ERAf have no further symptomatic Af during long-term follow-up.Therefore,temporary antiarrhythmic drug therapy may be more appropriate than early repeat ablation in patients with ERAf.更多还原