导管射频消融治疗房颤时肺静脉电位振幅变化趋势的分析

Alteration of pulmonary vein potential amplitude in treatment of atrial fibrillation with radiofrequency catheter ablation

摘要:

目的 探讨肺静脉电位（PVP）指导的心房颤动（AF）射频消融治疗中PVP振幅（PVPA）与消融时间之间的关系以及不同类型AF在PVPA和消融时间之间是否存在差异。方法 连续选取2014年1月至2015年6月解放军总医院心内科住院且行肺静脉隔离（PVI）治疗的AF患者43例，按房颤类型分为阵发性AF组（n＝34）和持续性AF组（n＝9），比较两组患者PVPA、消融时间以及术后12个月AF的复发率。结果 PVPA与消融时间之间存在线性相关，PVPA越大消融时间越长。两组患者在PVPA和消融时间上无显著性差异（P＞0.05）。持续性AF组复发率显著高于阵发性AF组（55.6% vs 17.6%，P＜0.05）。结论 在PVI治疗中，PVPA是指导消融的一个重要指标，但对于持续性AF患者除传统PVI外还应采取其他辅助消融策略，以提高其远期成功率。

Abstract:

Objective To investigate the relationship between pulmonary vein potential amplitude (PVPA) and ablation time in the treatment of atrial fibrillation (AF) with PVP guided radiofrequency ablation. Methods A total of 43 AF patients undergoing pulmonary vein isolation (PVI) in our department from January 2014 to June 2015 were recruited in this study. They were divided into paroxysmal AF group (n＝34) and persistent AF group (n＝9). PVPA, ablation time and recurrence rate in 12 months after treatment were compared between the 2 groups. Results There was a linear correlation between PVPA and ablation time, with the larger PVPA the longer ablation time. No significant difference was found in the PVPA and ablation time between the 2 groups (P＞0.05). In 12 months after the treatment, the recurrence rate was 17.6% and 55.6%, respectively for the paroxysmal and persistent AF groups (P＜0.05). Conclusion PVPA is an important index to direct radiofrequency ablation in PVI. But other AF ablation techniques should be used in the patients with persistent AF to improve long-term recurrence-free rate.