【摘要】 目的探究肺静脉隔离联合非肺静脉触发灶消融对低射血分数的阵发性心房颤动(以下简称房颤)患者远期预后的影响。方法选取天津市第五中心医院接受导管消融术且左室射血分数(LVEF)<45%的阵发性房颤患者87例,根据治疗方式的不同分为Ⅰ组(肺静脉隔离联合非肺静脉触发消融)及Ⅱ组(肺静脉隔离)。随访2年,运用Log-rankχ~2比较两组未复发率的差异,Cox回归识别低射血分数的阵发性房颤患者术后复发的影响因子。结果两组患者随访后2年手术成功率、非肺静脉触灶及LVEF比较,差异有统计学意义(P<0.05)。Ⅰ组未复发率高于Ⅱ组(P<0.05)。冠状动脉疾病、非肺静脉触发灶、非肺静脉触发灶消融及LVEF是低射血分数合并阵发性房颤患者术后复发的独立影响因素(P<0.05)。结论肺静脉隔离联合非肺静脉触发灶消融对低射血分数的房颤患者远期疗效较好,值得临床推广。更多还原

【Abstract】 Objective To investigate the effect of non-pulmonary vein trigger ablation combined with pulmonary vein isolation on the long-term prognosis of paroxysmal atrial fibrillation patients with low ejection fraction. Methods A total of 87 patients with paroxysmal atrial fibrillation and left ventricular ejection fraction(LVEF) <45% who were treated by catheter ablation in Tianjin 5 th Central Hospital were enrolled. The patients were divided into group I(non-pulmonary vein trigger ablation combined with pulmonary vein isolation) and group Ⅱ(pulmonary vein isolation) according to the treatment modalities. After 2 years of follow-up, Log-rank χ~2 was used to compare the prognosis of the two groups, and the factors affecting postoperative recurrence in the patients was analyzed by Cox regression. Results At the end of follow-up, the 2-year success rate of operation and LVEF in the group Ⅰ were higher than those in the group Ⅱ(P < 0.05), while the number of recurrence patients with non-pulmonary vein trigger in the group Ⅱ was larger than that in the group Ⅰ(P < 0.05). Coronary artery disease, non-pulmonary vein triggering lesions, non-pulmonary venous trigger ablation and LVEF were the independent influencing factors for postoperative recurrence in atrial fibrillation patients with low ejection fraction(P < 0.05). Conclusions Pulmonary vein isolation combined with non-pulmonary vein trigger ablation has good long-term effect on atrial fibrillation patients with low ejection fraction.更多还原