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目的探究老年心房颤动行房室结消融联合永久起搏器治疗的临床疗效。方法 40例老年心房颤动患者,均采用房室结消融联合永久起搏器治疗,首先进行右侧股静脉穿刺(植入临时起搏导管),并且在患者的右室心尖进行临时起搏,随后,在患者的右侧股静脉处植入房室结消融导管,并且记录房室结交界区域内的希氏束电位,将房室结放电消融,待房室传导受到阻滞后,将永久起搏器植入。术后,对患者进行为期6个月的随访调查,观察患者心功能、运动耐力及生活质量的改善情况。结果术后3、6个月40例患者的左室舒张末期内径(LVEDD)、美国纽约心脏病协会(NYHA)分级、左室射血分数(LVEF)、6 min步行距离均优于手术前(P<0.05),且术后6个月LVEDD、NYHA分级、LVEF、6 min步行距离均优于术后3个月(P<0.05)。术后6个月生活质量改善率95.00%高于术后3个月77.50%(P<0.05)。结论老年心房颤动行房室结消融联合永久起搏器治疗,其临床疗效显著,能够有效的改善患者的心功能、运动耐力及生活质量。
Objective To investigate the clinical effect of atrioventricular node ablation combined with permanent pacemaker in elderly patients with atrial fibrillation. Methods Forty elderly patients with atrial fibrillation were treated with atrioventricular node ablation combined with a permanent pacemaker. First, right femoral vein puncture (temporary pacing catheter) was performed, and temporary pacing was performed on the right atrium of the patient. , The patient’s right femoral vein implanted atrioventricular node ablation catheter, and record the junction of atrioventricular node His bundle potential, the atrioventricular node radiofrequency ablation, atrioventricular conduction block, will be permanently Implantation of pacemaker. After surgery, the patients were followed up for 6 months to observe the improvement of cardiac function, exercise tolerance and quality of life. Results LVEDD, NYHA classification, left ventricular ejection fraction (LVEF) and walking distance at 6 min in 40 patients at 3 and 6 months postoperatively were all better than preoperative P <0.05). LVEDD, NYHA classification, LVEF, 6 min walking distance were all better than those of 3 months postoperatively (P <0.05). The improvement rate of quality of life 6 months after operation was 95.00% higher than 77.50% 3 months after operation (P <0.05). Conclusion Atrial fibrillation in elderly patients with atrioventricular node ablation combined with permanent pacemaker treatment, the clinical efficacy was significant, can effectively improve the patient’s cardiac function, exercise tolerance and quality of life.