目的：总结心内直视下同期双极射频消融治疗先天性心脏病合并心房颤动的临床经验。方法：2008年4月-2009年3月，4例先天性心脏病合并心房颤动患者在本科接受体外循环心脏直视手术及双极射频消融手术治疗，本文对此4例患者的临床资料进行回顾性分析。结果：4例手术均顺利完成，手术时间（228.25±31.75）min，体外循环时间（93.25±22.50）min，主动脉阻断时间（57.50±20.75）min，双极射频消融时间（17.75±2.25）min。3例心脏自动复跳，1例电击除颤1次后复跳，均转为窦性心律。无高度房室传导阻滞发生，无手术死亡。术后平均住院（9.25±1.25）d，出院时心律均为窦性。4例术后随访5~6年，均维持窦性心律，右心房内径较术前缩小，差异有统计学意义（P<0.05）。结论：心内直视下同期双极射频消融治疗先天性心脏病合并心房颤动患者，手术安全，术后长期窦性心律维持率高。%Objective: To summarize the clinical experience of the hameochronous bipolar radiofrequency ablation for congenital heart disease associated with atrial fibrillation under the open heart surgery.Method: From April 2008 to March 2009, 4 cases of congenital heart disease patient associated with atrial fibrillation were received the open heart surgery and the hameochronous bipolar radiofrequency ablation operation by cardiopulmonary bypass. The clinical data of 4 cases was analyzed retrospectively.Result: All operation achieved success. Operation time, cardiopulmonary bypass time, aortic clamp time and bipolar radiofrequency ablation operation time were (228.25±31.75), (93.25±22.50), (57.50±20.75) and (17.75±2.25) minutes respectively. 3 patients were in sinus rhythm after the hearts beated again and 1 patient with ventricular fibrillation returned to sinus rhythm by electric defibrillation. No high degree atrioventricular block and death were found. Postoperative hospital stay was mean (9.25±1.25) days. All patients were in sinus rhythm when they were discharged from hospital. 4 patients were followed up from 5 to 6 years, and all were keeping in sinus rhythm. The postoperative right atrial diameter was reduced, compared with the preoperative right atrial diameter, the difference was statistically significant(P<0.05).Conclusion: The hameochronous bipolar radiofrequency ablation for congenital heart disease associated with atrial fibrillation under the open heart surgery is a safe procedure, and has a high maintenance ratio of sinus rhythm for long-term.
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