【摘要】 目的探讨射频消融术后心房颤动复发病人的临床特点,同时通过与首次手术病人比较评价其再次行导管射频消融术的安全性。方法选取2009年10月—2011年6月在江苏省人民医院心脏科行射频消融术的心房颤动病人435例,其中首次射频消融术345例(首次手术组),二次射频消融术90例(再次手术组)。比较两组心房颤动类型、心脏超声指标、生化指标以及手术并发症等,并在术后1个月、3个月、6个月、12个月进行临床随访。结果两组病人心房颤动类型、心脏超声指标、生化指标等临床资料比较差异均无统计学意义(P>0.05);再次手术组并发症发生率低于首次手术组,但差异无统计学意义(P>0.05);两组手术随访1年,再次手术组复发率低于首次手术组(20.00%与33.33%,P=0.014);再次手术组阵发性心房颤动复发率明显低于首次手术组(16.88%与29.00%,P=0.033)。结论心房颤动复发病人行再次射频消融手术与首次手术相比同样安全,复发病人尤其是阵发性心房颤动术后复发病人可以尝试再次射频消融手术治疗。更多还原

【Abstract】 Objective To investigate the clinical characteristics of patients with recurrent atrial fibrillation and to evaluate the safety of re-catheter radiofrequency ablation compared with that in patients undergoing first operation.Methods Four hundred and thirty-five patients with atrial fibrillation undergoing catheter radiofrequency ablation were selected,including 345 patients with first ablation(first ablation group) and 90 patients with repeat ablation(repeat ablation group).The types of atrial fibrillation,echocardiographic indicators,biochemical indicators,and surgical complications were compared between two groups.At 1 month,3 months,6 months,and 12 months after operation,the patients were followed up in the outpatient department for dynamic electrocardiogram examination.Results There was no significant difference in atrial fibrillation type,cardiac ultrasound index,biochemical index and other clinical data between two groups(P>0.05).The complication rate of repeat ablation group was lower than that of first ablation group,but there was no significant difference(P>0.05).The recurrence rate of repeat ablation group was lower than that of first ablation group(20.00% vs 33.33%,P=0.014).The recurrence rate of paroxysmal atrial fibrillation in repeat ablation group was lower than that in first ablation group(16.88% vs 29.00%,P=0.033).Conclusion The repeat ablation for atrial fibrillation is as safe as the first ablation in patients with atrial fibrillation.It is recommended that patients with recurrent atrial fibrillation,especially those with recurrent paroxysmal atrial fibrillation,should try repeat ablation.更多还原