论文部分内容阅读
探讨射频消融 (RFCA)治疗心功能障碍患者心动过速的安全性。对 36例不同程度心功能障碍患者采用药物或介入方法治疗原发病、纠正心功能、RFCA根治心动过速。结果 :经术前准备 ,所有患者心功能均改善 1～ 2级 ,恢复至NYHAⅡ～Ⅰ级以上。首次消融成功 33例 ,成功率 91.7% (33/ 36 )。未成功的 3例中 ,2例 (1例左中间隔旁道及 1例右前壁旁道 )行第 2次消融成功 ,1例不纯性心房扑动消融 2次均未成功改服胺碘酮疗效确切。总成功率97.2 % (35 / 36 )。 6例合并冠心病心绞痛的患者有 4例行左前降支经皮冠状动脉成形术及支架置入术 ,2例行RFCA后心绞痛不再发作。 2例合并风湿性心脏病者有 1例同期行二尖瓣球囊扩张成形术 ,1例择期外科换瓣。经 6 .4±2 .4 (2～ 10 )年的随访无 1例复发。结论 :认真做好围术期处理 ,心功能障碍患者心动过速的RFCA治疗同样具有高成功率和高安全性。
To investigate the safety of radiofrequency catheter ablation (RFCA) in the treatment of tachycardia in patients with cardiac dysfunction. Thirty-six patients with varying degrees of cardiac dysfunction were treated with drugs or interventions to treat primary disease, correct cardiac function, and RFCA to cure tachycardia. Results: After preoperative preparation, the cardiac function of all patients improved by 1 ~ 2 and returned to NYHA Ⅱ ~ Ⅰ level. The first successful ablation in 33 cases, the success rate of 91.7% (33/36). Among the three unsuccessful cases, 2 cases (1 case of the left middle septum and 1 case of the right anterior wall) succeeded in the second ablation, and 1 case of impure atrial flutter ablation did not succeed in 2 cases Iodine curative effect is exact. Assembly success rate of 97.2% (35/36). Among the 6 patients with coronary heart disease and angina pectoris, 4 patients underwent left anterior descending coronary artery angioplasty and stenting, and 2 patients underwent angina without recurrence after RFCA. One of the two patients with rheumatic heart disease underwent mitral balloon angioplasty and one had elective surgery for valve replacement. There was no recurrence after one-year follow up of 6.4 ± 2.0 (2-4 years). CONCLUSIONS: Perioperative management is well performed. RFCA for tachycardia in patients with cardiac dysfunction also has a high rate of success and safety.