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目的 探讨经导管射频消融治疗阵发性心房颤动 (房颤 )的安全性、有效性以及对生活质量的影响。方法 30例药物难治性阵发性房颤 ,在环状电极导管 (Lasso导管 )指导标测下行肺静脉或上腔静脉电隔离 ,术后随访并行隔离术前后生活质量调查。结果 有 2 9例达消融终点 ,随访 1～ 2 6个月 ,17例消融成功 ,无需药物可以维持窦性心律 ,加用以前无效的抗心律失常药物后 ,有 2 2例无房颤复发。生活质量(QOL)调查示隔离术前后相比 ,SF 36量表中除肌体疼痛差异无显著性外 ,其它 7项指标 :躯体功能、躯体角色、总的健康状况、活力、社会功能、情感角色和心理健康 ,术后均有改善 (P <0 0 5 ) ;而症状列表中除胸痛外 ,心悸、心动过速、呼吸困难、头昏、活动受限 ,术后均有改善 (P <0 0 5 )。结论 部分药物难治性房颤患者可行射频导管消融肺静脉电隔离治疗 ,成功地消除房颤可明显提高患者的QOL且改善症状。
Objective To investigate the safety and efficacy of transcatheter radiofrequency catheter ablation of paroxysmal atrial fibrillation (AF) and its impact on quality of life. Methods Thirty patients with refractory paroxysmal atrial fibrillation underwent electrical isolation of the pulmonary veins or superior vena cava under the guidance of a ring-shaped lead (Lasso catheter). The quality of life (QOL) was analyzed before and after the operation. RESULTS: Twenty-nine patients achieved ablation endpoints, and were followed up for 1 to 26 months. Twenty-seven patients successfully ablated. No drug was required to maintain sinus rhythm. Twenty-two patients without atrial fibrillation were recruited after the previous anti-arrhythmic drugs were used. Quality of life (QOL) survey showed that before and after isolation compared SF36 scale in addition to body pain was no significant difference, the other seven indicators: physical function, physical role, the general state of health, vitality, social function, emotion (P <0 05). In addition to chest pain, heart palpitations, tachycardia, dyspnea, dizziness, limited mobility and postoperative improvement were all found in the list of symptoms (P < 0 0 5). Conclusion Some patients with refractory atrial fibrillation can be treated with radiofrequency catheter ablation of pulmonary vein isolation. Successful elimination of atrial fibrillation can significantly improve QOL and improve symptoms in patients.