心脏不停跳心内直视下射频消融改良迷宫术治疗慢性心房颤动

摘要

目的:评价心脏不停跳心内直视下行瓣膜置换术加射频消融改良迷宫术的安全性和疗效.方法:采用射频消融及无水酒精注射方式,对83例心脏瓣膜病变合并慢性心房颤动患者于体外循环心脏不停跳下行瓣膜置换术的同时实施射频消融改良迷宫术.结果:全组无院内死亡,术后心房颤动全部消失;实施射频消融改良迷宫术过程耗时21～32 min,平均24 min.随访6～42个月,其中77例维持窦性心律,心房颤动复发6例,转复率为92.77%;心脏超声心动图复查提示左心房、左心室较术前明显缩小.无房室传导阻滞、无出血及血栓复发.结论:浅低温心脏不停跳心内直视下应用射频消融改良迷宫术操作简单,疗效确切且安全性高.%Objective:To evaluate the safety and efficacy of radiofrequency modified maze procedure for atrial fibrillation treatment during the intracardiac beating heart valve replacement surgery. Methods: Eighty-three patients with heart valve disease complicated with chronic atrial fibrillation were treated by radiofrequency ablation and percutaneous ethanol injection during the intracardiac beating heart valve replacement surgery. Results:There was no hospital mortality. Postoperative atrial fibrillation disappeared. Implementation of the radiofrequency modified maze procedure process spent 21～32 min, with an average of 24 min.During 6 to 42 months follow-up, 77 cases were sinus rhythm 6 cases were recurrence of atrial fibrillation. The cardioversion rate was 92. 77％. Echocardiography showed that the left atrium and left ventricle was significantly reduced as compared with those before the procedure. There was no atrioventricular block, recurrence of bleeding and thrombosis. Conclusion:During mild hypothermia the intracardiac beating heart valve replacement surgery, the application of radiofrequency modified maze procedure is simple and effective, and safe.