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中国经导管消融治疗心房颤动注册研究 被引量:29

The registration study of catheter ablation in patients with atrial fibrillation in China
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摘要 目的 分析截止2005年我国经导管消融治疗心房颤动(房颤)的整体情况和发展趋势。方法 2006年3月向全国开展经导管消融治疗房颤的医院发出注册登记表,6月收回并汇总。根据各家医院提供的资料,对我国经导管消融治疗房颤病例资料进行回顾性分析。结果 本次调查共收到40家医院自1998年以来共3196例注册登记资料,其中男性2193例,女性1003例,平均年龄(54.77±5.98)岁。阵发性房颤占85.67%,持续性房颤占11.51%,永久性房颤占2.82%。45.93%的患者合并1种或1种以上的基础心脏疾病,伴左心房血栓的患者占0.9%。左心房直径(37.02±3.98)mm,左心室舒张末内径(46.81±4.05)mm,左心室射血分数0.59±0.06。经导管消融治疗房颤的术式主要有5种:(1)局灶消融术;(2)肺静脉节段性消融术;(3)环肺静脉消融术;(4)左心房基质改良术;(5)肺静脉前庭改良术。消融能源中,射频占95.96%,超声占3.00%,冷冻占1.22%。5种术式的终点不尽相同,各术式亦无统一终点。影响成功率和复发率的因素有:性别、年龄、基础疾病、心脏结构与功能、术者经验、房颤类型、房颤病程、消融术式、消融能源等。术后抗心律失常药物的应用明显减少,但抗凝治疗有所加强。总的并发症发生率为7.48%,严重并发症如心脏压塞和肺静脉狭窄3.19%。结论 建议在相关条件较好的医院,可将经导管消融作为无基础心脏疾病的阵发性房颤的一线治疗方法。 Objective To analyze the status and trend of the development of catheter ablation of atrial fibrillation (AF) in China up to 2005. Methods In March 2006, a registry form was dispatched to all hospitals performing catheter ablation of AF. After items in regard of catheter ablation of AF during 1998 to 2005 had been Idled by each hospital, the forms were collected for analysis. Results A total of 3 196 cases from 40 hospitals were registered, malein 2 193 cases, femalein 1 003 cases. Average age was(54. 77 ±5. 98)years. The proportions of paroxysmal, persistent and permanent AF were 85.67%, 11.51% and 2.82%, respectively. 45.93% patients had one or more than one basic disease, left atrium thrombus accounted for 0. 9%. Diameter of left atrium was( 37. 02 ± 3. 98) mm, the left ventricular end-diastolic dimension was (46.81 ± 4.05)mm, and left ventricular ejection fraction was 0.59 ±0. 06. The main procedures included fecal ablation, segmental PV ablation, circumferential ablation of PV ostia, left atrial substrate modification and PV antrum modification. The energy used for catheter ablation included radiofrequency (95. 96% ), ultrasound (3. 00% ) and cryoablation ( 1.22% ). The end points of five procedures were different from each other. Factors impacting success and recurrence rates included gender, age, basic diseases, cardiac function and structure, experience of the operators, type of AF, course of AF, procedures and energy. After catheter ablation, the applications of antiarrhythmia drug decreased markedly, and the anticoagulation therapy strengthened. Overall rate of complication was 7. 48%, Severe complications, such as pericardial tampenade and pulmonary vein stenosis only account for 3. 19%. Condusions It is proposed that catheter ablation could be the first-line therapy for patients with paroxysmal AF and without basic diseases in qualified hospitals.
作者 黄从新 张澍 马长生 曹克将 杨延宗 刘旭 刘少稳 马坚 吴书林 江洪 黄德嘉 王方正 陈新 HUANG Cong- xin , ZHANG Shu, MA Chang-sheng, CAO Ke-jiang, YANG Yan-zong, LIU Xu,LIU Shao-wen,MA Jian,WU Shu-Lin,JIANG Hong,HUANG De-jia, WANG Fang-zheng, CHEN Xin, et al. (Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan 430060, China )
出处 《中华心律失常学杂志》 2006年第6期 468-474,共7页 Chinese Journal of Cardiac Arrhythmias
关键词 心房颤动 心律失常 导管消融 注册 Atrial fibrillation Arrhythmia Catheter ablation Registry
作者简介 中华医学会心电生理和起搏分会心房颤动治疗专家工作组 通信作者.黄从新(Email:wurmheart@vip.163.com或huangcongxin@yahoo.com.cn) 中华医学会心电生理和起搏分会心房颤动治疗专家工作组 中华医学会心电生理和起搏分会心房颤动治疗专家工作组 中华医学会心电生理和起搏分会心房颤动治疗专家工作组 中华医学会心电生理和起搏分会心房颤动治疗专家工作组 中华医学会心电生理和起搏分会心房颤动治疗专家工作组 中华医学会心电生理和起搏分会心房颤动治疗专家工作组 中华医学会心电生理和起搏分会心房颤动治疗专家工作组 中华医学会心电生理和起搏分会心房颤动治疗专家工作组 中华医学会心电生理和起搏分会心房颤动治疗专家工作组 中华医学会心电生理和起搏分会心房颤动治疗专家工作组 中华医学会心电生理和起搏分会心房颤动治疗专家工作组 中华医学会心电生理和起搏分会心房颤动治疗专家工作组
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