右心室流出道起源室性心律失常行心脏射频消融术的远期效果

摘要

目的 探讨右心室流出道起源室性心律失常行心脏射频消融术的远期效果.方法 选取2015年1月至2017年6月于河南周口市中心医院心内科所收治的右心室流出道起源室性心律失常患者80例作为研究对象,根据标测方法的不同,将所有入选患者随机分成对照组和研究组,每组各40例,对照组应用电生理检测与射频消融治疗,研究组采用三维电解剖标测和射频消融进行治疗.对比两组患者的治疗效果、心功能情况、并发症发生情况以及生活质量(QOL)评分.结果 治疗1年后,研究组患者的临床疗效显著高于对照组(P＜0.05);研究组并发症发生率显著低于对照组(P＜0.05);治疗前两组患者每搏输出量(SV)、心脏指数(CI)、心输出量(CO)及心脏射血分数(EF)等心功能指标均无明显区别(P＞0.05),治疗后研究组患者的各项心功能指标明显高于对照组(P＜0.05);研究组的QOL评分显著高于对照组(P＜0.05).结论 采用三维心脏射频消融对右心室流出道起源室性心律失常患者实施治疗,可取得很好的治疗效果,不仅可以改善患者心功能、提高患者日后的生活质量,而且此方法安全有效,使治疗效果更加理想,临床上值得进一步推广使用.%Objective To discuss the long-term effect of cardiac radiofrequency ablation (RFA) on ventricular arrhythmias (VA) originated from right ventricular outflow tract (RVOT). Methods The patients with VA originated from RVOT (n=80) were chosen from Department of Cardiology of Central Hospital of Zhoukou City in Henan Province from Jan. 2015 to June 2017. All patients were randomly divided into control group and study group (each n=40) according to different mapping methods. The control group was treated with electrophysiological examination and RFA, and study group was treated with three-dimensional electro-anatomical mapping and RFA. The curative effect, heart function, incidence of complications and scores of quality of life (QOL) were compared between 2 groups. Results After treatment for 1 y, the clinical efficacy was significantly higher (P<0.05), and incidence of complications was significantly lower (P<0.05) in study group than those in control group. The indexes of heart function including stroke volume (SV), cardiac index (CI), cardiac output (CO) and ejection fraction (EF) had no significant differences between 2 groups before treatment (P>0.05), and all indexes were significantly higher in study group than those in control group after treatment (P<0.05). The scores of QOL were significantly higher in study group than those in control group (P<0.05). Conclusion The therapy of three-dimensional RFA can obtain higher curative effect in patients with VA originated from RVOT. It can improve patients’ heart function and QOL, and is safe and effective. The therapy will get ideal curative effect, which is worth clinical promoting further.