首页|老年房颤患者高功率、短时程消融技术的安全性及有效性研究

老年房颤患者高功率、短时程消融技术的安全性及有效性研究

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目的 探讨老年房颤患者应用高功率、短时程消融技术的安全性及有效性.方法 随机选取2021年1月至2023年6月住院本科的老年房颤患者接受高功率、短时程导管消融54例(观察组),同期接受常规的低功率、长时程消融组54例(对照组),比较两组射线量、消融时间、盐水灌注量、肺静脉单圈隔离率、手术并发症等.术后随访1年,比较两组手术成功率等.结果 观察组射线量、消融时间、盐水灌注量明显低于对照组(P<0.01)[(51.30±14.71)mGy vs.(77.77±13.97)mGy,(57.98±16.95)min vs.(82.19±16.78)min,(1284.31±212.07)mL vs.(1783.33±242.25)mL,P<0.01].两组肺静脉单圈隔离率类似,两组均无严重手术并发症.对照组有17例房颤复发,高于观察组(9例复发),但两组比较差异无统计学意义(P=0.072).KM曲线分析观察组比对照组窦性心律维持时间更长(Log Rank P=0.043).结论 老年房颤患者运用高功率、短时程射频消融能显著缩短消融时间,降低术中盐水灌注量及射线量,具有更长的窦性心律时间,是一种安全有效消融方式.
The study on the safety and effectiveness of high power short duration ablation technique in elderly patients with atrial fibrillation
Objective To explore the safety and effectiveness of high power short duration(HPSD)ablation technique in elderly patients with atrial fibrillation.Methods A total of 108 elderly patients with atrial fibrillation in the Department of Cardiology,the First Affiliated Hospital of Bengbu Medical University from January 2021 to June 2023 were randomly divided into the observation group(54 patients),who underwent HPSD catheter ablation and the control group(54 patients),who received conventional low power long duration(LPLD)catheter ablation.The radiation dose,ablation time,fluid infusion volume,pulmonary vein single lap isolation,and surgical complications were compared between the two groups.Follow up for 1 year after surgery to compare the success rates of the two groups.Results The observation group had significantly lower radiation dose[(51.30±14.71)mGy vs.(77.77±13.97)mGy,P<0.01],ablation time[(57.98±16.95)min vs.(82.19±16.78)min,P<0.01]and saline infusion volume[(1284.31±212.07)mL vs.(1783.33±242.25)mL,P<0.01]compared with the control group.The pulmonary vein single lap isolation rates were similar in the two groups,and there were no serious surgical complications in the two groups.There were 17 cases of atrial fibrillation recurrence in the control group,higher than in the observation group(9 cases of recurrence),but there was no statistically significant difference between the two groups(P=0.072).KM curve analysis showed that the maintenance time of sinus rhythm in the observation group was longer than that in the control group(Log Rank P=0.043).Conclusions HPSD can significantly shorten the ablation time,reduce intraoperative saline infusion and radiation dose,and have a longer sinus rhythm time in elderly patients with atrial fibrillation.It is a safe and effective ablation method.

Atrial fibrillationRadiofrequency catheter ablationHigh power short duration(HPSD)SafetyEffectiveness

张先林、李金龙、路桥、徐文慧、汤阳、朱建、唐碧

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蚌埠医科大学第一附属医院心血管内科,蚌埠 233000

蚌埠医科大学临床医学院,蚌埠 233000

心房颤动 射频消融 高功率短时程 安全性 有效性

2024

中华急诊医学杂志
中华医学会

中华急诊医学杂志

CSTPCD北大核心
影响因子:1.556
ISSN:1671-0282
年,卷(期):2024.33(12)