射频消融术对频发室性早搏患者左心室功能的影响

摘要

目的 探讨射频消融术能否纠正左心室功能失调.方法 将符合入组标准的患者49例分成射频消融组(35例)和对照组(14例).射频消融组患者行射频消融治疗,对照组患者接受药物干预.患者均随访3～6个月,评估2组患者室性期前收缩负荷(PVC)、左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)及左心室收缩末期内径(LVESD)等情况.结果 治疗前射频消融组与对照组PVC、LVEF、LVEDD、LVESD差异均无统计学意义[(24±11)％比(21±7)％；(63±9)％比(60±6)％；(50±4) mm比(49±5)mm; (32±5)mm比(34 ±3) mm;均P＞0.05].治疗后射频消融组PVC明显减低[(8±11)％比(24±11)％,t =6.149,P＜0.01],LVEF明显增高[(68±5)％比(63±9)％,t=3.426,P＜0.01],LVEDD明显减小[(48±3)mm比(50±4)mm,t=3.539,P＜0.01],LVESD明显减小[(3l±3)mm比(32±5)mm,t=2.665,P ＜0.05].对照组治疗后PVC增高[(22±5)％比(21±7)％,t=3.180,P＜0.05],LVEF减低[(59±5)％比(60±6)％,t=2.754,P＜0.05],LVEDD增加[(50±5)mm比(49 ±5)mm,t =5.551,P＜0.01],LVESD增加[(35 ±3)mm比(34±3)mm,t=2.599,P＜0.05].射频消融组治疗后PVC、LVEF、LVESD与对照组治疗后比较差异均有统计学意义(均P＜0.01).结论 频发室性早搏的患者更易发生左心室扩大和收缩功能失调.对药物治疗不满意的频发室性早搏患者通过射频导管消融治疗可以获得满意的疗效.对有适应证者应尽早行射频消融术根治.%Objective To explore whether radiofrequency catheter ablation can reverse left ventricular dysfunction.Methods Totally 35 patients for radiofrequency catheter ablation (RFCA) and 14 patients who took antiarrhythmic drugs but did not accept radiofrequency catheter ablation were enrolled.All patients were evaluated at baseline and 3-6 months followed up in terms of premature ventricular complexes (PVC),left ventricular ejection fraction (LVEF),left ventricular end-diastolic dimension (LVEDD) and left ventricular end systolic diameter (LVESD).Results The patients in both RFCA group and control group were matched in PVC,LVEF,LVEDD and LVESD at baseline [(24 ± 1 1) ％ vs (21 ± 7) ％ ; (63 ± 9) ％ vs (60 ± 6) ％ ; (50 ± 4) mm vs (49 ± 5) mm;(32 ±5)mm vs (34 ±3)mm; all P ＞0.05].Compared to baseline,the patients in the RFCA group showed significantly decreased PVC [(8 ± 11) ％ vs (24 ± 11) ％,t =6.149,P ＜ 0.01],increased LVEF [(68 ± 5) ％ vs (63 ± 9) ％,t =3.426,P ＜ 0.01] and decreased LVEDD and LVESD [(50 ± 4) mm vs (48 ± 3) mm,t =3.539,P ＜ 0.01 ; (31 ± 3) mm vs (32 ± 5) mm,t =2.665,P ＜ 0.05].However,the patients in the control group showed significantly increased PVC [(22 ± 5) ％ vs (21 ± 7) ％,t =3.180,P ＜ 0.05],decreased LVEF [(59 ± 5) ％ vs (60 ±6)％,t =2.754,P＜0.05],and increased LVEDD and LVESD[(50 ±5)mm vs (49 ±5)mm,t =5.551,P ＜ 0.05 ; (35 ± 3) mm vs (34 ± 3) mm,t =2.599,P ＜ 0.05].Conclusion Idiopathic PVGs may represent a form of cardiomyopathy that can be reversed by catheter ablation of the PVCs.