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环肺静脉隔离与抗心律失常药物治疗房颤的对比研究

王会永   

  1. 天津医科大学第二医院
  • 收稿日期:2011-05-16 修回日期:2011-10-20 出版日期:2012-08-15 发布日期:2012-08-15
  • 通讯作者: 王会永

Comparison of circumferential pulmonary vein isolation and antiarrhythmic drug therapy for atrial fibrillation

Hui-Yong WANG   

  • Received:2011-05-16 Revised:2011-10-20 Published:2012-08-15 Online:2012-08-15
  • Contact: Hui-Yong WANG

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摘要： 摘要 目的：比较环肺静脉隔离和抗心律失常药物治疗心房颤动维持窦性心律的疗效。方法：选取402例房颤患者分为消融组（n=143）和药物组（n=259），其中阵发性房颤344例，持续性房颤58例。收集患者基本资料，对其定期进行随访，以房颤复发为主要研究终点，采用Kaplan-Meier方法和log-rank检验比较两组房颤复发随随访时间的累积复发率有无统计学意义。结果：消融组维持窦性心律者82例（57.3%），总有效率为83.2%。药物组维持窦性心律者63例（24.3%），总有效率为50.2%。Kaplan-Meier生存分析显示：消融组对窦律维持率高于药物组，两组经log-rank检验，差异有统计学意义（P < 0. 001）。多因素分析显示：环肺静脉隔离是影响房颤复发的保护因素（OR= 0.395，P < 0. 001）。房颤病程、左房大小是影响房颤复发的独立危险因素（OR分别为1.024、1.048，P < 0. 05），结论：环肺静脉隔离可显著减低房颤复发，使更多的患者维持窦性心律，优于抗心律失常药物治疗。

关键词: 心房颤动, 环肺静脉隔离, 抗心律失常药物治疗, 复发, 随访

Abstract: Comparison of circumferential pulmonary vein isolation and antiarrhythmic drug therapy for atrial fibrillation WANG Hui-yong；LI guang-ping；XU Gang；CHEN Xin；YE Lan；XU Yan-min Cardiology Department，Second Hospital of Tian jin Medical University ,Tian jin 300211, China Abstract Objective: to determine the clinical efficacy of Circumferential pulmonary vein isolation(CPVI) compared with antiarrhythmic drug therapy (ADT) on sinus rhythm (SR) maintenance in patients with atrial fibrillation (AF). Methods: 402 patients with atrial fibrillation were divided two groups，CPVI group(n=143) and ADT group(n=259). By clinic service ,telephone and letter, the patients after discharged were followed up .The primary end point was AF recurrence.The survival analysis was performed the Kaplan-Meier analysis and log-rank test. Results: During following-up 82 patients in the CPVI group maintained sinus rhythm(SR),while 63 patients in the ADT group were free from recurrent AF.By log-rank test and Kaplan-Meier analysis, 57.3%of patients in the CPVI group and 24.3% of those in the ADT group were no recurrent AF (P <0.001). The multivariate analysis showed AF duration ,left atial diameter, treatment assignment were independent predictors of AF recurrences.Conclusion: Circumferential pulmonary vein isolation is superior to Antiarrhythmic drugs for preventing AF recurrence in patients with atrial fibrillation．

Key words: Atrial fibrillation, Circumferential pulmonary vein isolation, Antiarrhythmic drug treat, Recurrence, Follow up