合并窦房结病变的房颤患者射频消融术后应用益气复脉颗粒疗效探讨

摘要

目的:探讨合并窦房结病变(SND)的房颤患者射频消融(RFCA)术后应用益气复脉颗粒的疗效.方法:回顾性分析2015年1月至2017年6月北京中医药大学东方医院收治的合并SND的阵发性房颤成功行RFCA,且不合并器质性心脏病患者22例.窦性心动过缓18例,其中合并窦性停搏6例;单纯窦性停搏4例.术后应用益气复脉颗粒8周,随访1年,评价房颤复发率、窦房结功能及中医证候.结果:早期复发4例,其中2个月后房颤自行消失3例.术后平均心率增加21例,且持续至1年.仍为严重窦性心动过缓而植入心脏起搏器1例.所有患者无≥3s窦性停搏.所有患者术后中医证候积分减少≥70%.结论:合并SND的房颤患者RFCA术后应用益气复脉颗粒,能减少房颤复发,改善窦房结功能,改善临床症状.%Objective:To evaluate the efficacy of Yiqi Fumai granule after radiofrequency catheter ablation ( RFCA) in the pa-tients who had concomitant sinus node dysfunction (SND) and atrial fibrillation (AF).Methods:Twenty-two patients with SND af-ter successful RFCA for AF in our hospital from January 2015 to June 2017 were retrospectively analyzed.18 patients had sinus bradycardia and 6 of them had concomitant sinus pauses.Only sinus pauses occurred in 4 patients.After RFCA,all patients were treated with Yiqi Fumai granule for 8 weeks.After 1-year follow up,recurrence of AF,sinus node function and traditional Chinese medicine (TCM) syndrome were assessed.Results:Early recurrence of AF was occurred in 4 patients,and 3 of them were free of recurrent AF at 2 months after RFCA.21 patients had a significant increase in mean heart rate during 1-year follow-up time.One patient had pacemakers implanted due to serious sinus bradycardia during follow -up time.None patient had sinus pauses ≥3 s.All 22 patients had a drastic reduction of ≥70%in TCM syndrome score during 1-year follow-up time.Conclusion:After RFCA of AF in patients who had concomitant SND and AF ,the application of Yiqi Fumai granule can reduce the recurrence of AF ,improve sinus node function and improve clinical symptoms.