阵发性房颤二代冷冻球囊消融术后早期复发率及其影响因素

发布时间：2018-04-24 06:33

  本文选题：二代冷冻球囊 + 早期复发率　； 参考：《浙江大学》2017年硕士论文

【摘要】：研究目的心房颤动(AF,简称房颤)是目前最常见的持续性心律失常。房颤在总人群的发病率较高,约1%-2%,并且随着年龄的增长,房颤的发病率也随之增长,有研究表明,在80岁以上的人群中甚至高达近8%。同时,除了房颤疾病自身的痛苦,房颤带来的各种并发症也让患者饱受折磨。随着射频消融术的出现,房颤的治疗迎来了里程碑式进展,第一次能通过微创手术进行根治,各中心手术成功率在50%-80%不等。而冷冻球囊消融术作为阵发性心房颤动的新消融手段,有Meta分析比较两者术后1年成功率显示两术式临床疗效相当[1]。现在,加以改进的二代冷冻球囊的问世,冷冻效率大大提高,冷冻消融技术得到了进一步提升。本文将就二代冷冻球囊消融术的早期复发率及复发因素进行探讨,以便早期进行干预治疗。研究方法这是一个单中心的回顾性研究,总共入选了 2016.8至2016.12期间共55例进行二代冷冻球囊消融的阵发性房颤患者。入选患者均用28mm冷冻球囊在肺静脉进行隔离,每次冷冻时间为3min,若未完全隔离行射频消融术隔离。术后1月、3月、6月时随访,每3个月行7天复查动态心电图。研究结果所有患者肺静脉电位都成功隔离,其中2人电复律后转窦性心律。术后3月共有6人复发,早期复发率11.8%。早期复发组与维持窦律组患者的基线NT-proBNP之间有显著性差异(早期复发组vs维持窦律组:287.0±195.9vs161.9±118.6 P0.05)。其他 hs-CRP 等没有显著性差异。结论阵发性房颤应用二代冷冻球囊消融术能较好地隔离肺静脉,术后具有较低的早期复发率。NT-proBNP是二代球囊冷冻术后早期复发率的影响因素。对于术前NT-proBNP高的患者术后更需密切关注,及时予早期治疗。
[Abstract]:Objective Atrial fibrillation (AF) is the most common persistent arrhythmia. The incidence of atrial fibrillation in the total population is higher, about 1- 2, and with the increase of age, the incidence of atrial fibrillation also increases. Some studies show that the incidence of atrial fibrillation is as high as nearly 8% in the population over 80 years old. At the same time, in addition to the pain of the disease itself, atrial fibrillation brings a variety of complications to the patient suffering. With the emergence of radiofrequency ablation, the treatment of atrial fibrillation has ushered in a milestone progress, the first time can be cured by minimally invasive surgery, the success rate varies from 50% to 80%. As a new method of ablation of paroxysmal atrial fibrillation, Meta analysis showed that the two methods had the same clinical effect. Now, with the advent of the improved second generation cryopreservation balloon, the efficiency of cryopreservation has been greatly improved, and the technique of cryoablation has been further improved. This article will discuss the early recurrence rate and recurrence factors of second generation cryopreservation balloon ablation in order to carry out early intervention therapy. Methods the study was a single-center retrospective study of 55 patients with paroxysmal atrial fibrillation who underwent second-generation balloon ablation between 2016.8 and 2016.12. All the patients were isolated in pulmonary vein with 28mm cryopreservation balloon for 3 mins each time. If not completely isolated, the isolation of radiofrequency ablation was performed. The patients were followed up for 1 month, 3 months and 6 months after operation. Results all patients were sequestered successfully, 2 of them switched to sinus rhythm after cardioversion. A total of 6 patients recurred at 3 months after operation, with an early recurrence rate of 11.8%. There was significant difference in baseline NT-proBNP between early recurrence group and maintenance sinus rhythm group (early recurrence group vs maintenance sinus rhythm group: 287.0 卤195.9vs161.9 卤118.6 P 0.05). There was no significant difference in other hs-CRP et al. Conclusion paroxysmal atrial fibrillation with second generation cryopreservation balloon ablation can well isolate pulmonary veins. The low early recurrence rate of paroxysmal atrial fibrillation. NT-proBNP is the influencing factor of the early recurrence rate after second generation balloon cryopreservation. Patients with high NT-proBNP need close attention and early treatment.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R541.75
，

本文编号：1795533