【摘要】 目的探讨肺静脉口部形态对冷冻消融60 s电隔离成功率的影响。方法入选2018年6月至2018年12月在泰达国际心血管病医院接受二代冷冻球囊消融治疗的症状性心房颤动(简称房颤)患者25例。在对每支肺静脉冷冻消融治疗中,根据电隔离时间(TTI)是否≤60 s分为2组。入院患者行CT肺静脉造影检查,测量每支肺静脉长径及短径,计算出偏心指数,排除左右肺静脉共干患者。结果左上肺静脉(LSPV)、左下肺静脉(LIPV)、右上肺静脉(RSPV)、右下肺静脉(RIPV)TTI≤60 s组的偏心指数均明显低于TTI>60 s组[(0.6±0.1) vs (0.7±0.2),P=0.016;(0.7±0.1) vs (0.8±0.1),P<0.001;(0.4±0.2) vs (0.8±0.1),P<0.001;(0.5±0.1) vs (0.6±0.1),P=0.002]。多因素Logistic回归分析显示,偏心指数为LSPV、LIPV、RSPV、RIPV TTI≤60 s独立影响因素(OR=0.384,95%CI 0.156～0.945,P=0.037;OR=0.012,95%CI 0.000～0.489,P=0.019;OR=0.375,95%CI 0.015～0.547,P=0.034;OR=0.27,95%CI 0.091～0.797,P=0.018)。结论房颤冷冻消融治疗过程中,四支肺静脉口部偏心指数越大,冷冻消融的困难越大。更多还原

【Abstract】 Objective To investigate the eccentricity index on the impact of time to isolation≤60 s in the cryoballoon ablation(CBA). Methods From June 2018 to December 2018,25 patients with symptomatic atrial fibrillation(AF) who had undergone CBA using second-generation in TEDA cardiovascular hospital were enrolled.According to the TTI in CBA for every pulmonary vein(PV),patients were divided into two groups(TTI≤60 s group,TTI>60 s group).Computer tomography pulmonary vein angiogram was undergone for all patients.Long(a) and short(b) axis measurements of the PV orifice were used to calculate the eccentricity index of the PV ostium. Result The eccentricity index of LSPV,LIPV,RSPV,RIPV in TTI≤60 s group were significantly less than that in TTI>60 s group[(0.6±0.1)vs(0.7±0.2),P=0.016;(0.7±0.1)vs(0.8±0.1),P<0.001;(0.4±0.2)vs(0.8±0.1),P<0.001;(0.5±0.1)vs(0.6±0.1),P=0.002].Multivariate regression analysis showed that the eccentricity index of LSPV,LIPV,RSPV,RIPV were highly related to the success of TTI≤60 s in CBA(OR=0.384,95%CI 0.156-0.945,P=0.037;OR=0.012,95%CI 0.000-0.489,P=0.019;OR=0.375,95%CI 0.015-0.547,P=0.034;OR=0.27,95%CI 0.091-0.797,P=0.018). Conculsion During the CBA of AF,the eccentricity index of pulmonary vein ostium is larger,CBA is often more difficult.[Chinese Journal of Cardiac Pacing and Electrophysiology,2020,34(3):265-268]更多还原