射频消融并植入心脏起搏器对房颤患者生活质量及心功能的影响的论文.docVIP

　　射频消融并植入心脏起搏器对房颤患者生活质量及心功能的影响的论文 【摘要】 目的：研究射频消融阻断房室传导同时植入永久性人工心脏起搏器对老年心房颤动（房颤）患者生活质量及心室结构和功能的影响。方法：2005年1月至2007年2月，7例老年房颤患者在长征医院接受射频消融阻断房室传导同时植入永久性人工心脏起搏器。术前及术后随访平均（7.7±4.9）月时进行生活质量问卷调查及心脏超声检查。结果：患者术后心悸、气短、头晕、胸痛评分较术前显著增加，分别提高120%、104%、94%和25%（p均lt;0.01）；总生活质量评分显著改善（plt;0.01）。与术前相比，7例患者术后室间隔舒张末期厚度（ivstd）［（11.6±2.3）mm∶（ 9.1±1.4）mm］、室间隔收缩末期厚度（ivsts）［（17.1±5.1）mm∶（11.8±1.2）mm］、左心室后壁舒张末期厚度（lvpm∶（9.1±1.4）mm］、左心室后壁收缩末期厚度（lvpm∶（12.2±0.8）mm]显著减小（p均lt;0.05）。3例植入房室全能型起搏器（ddd）的患者，术前后左室射血分无明显变化。心室按需型起搏器。6名患者术后左室收缩末期内径（lveds）较术前显著增大[(30.0±6.4)mm∶(34.0±6.4)mm,p=0.01]。无起搏失灵、起搏电极脱位、囊袋感染及起搏综合征等并发症。结论：对于症状严重、药物疗效差或不能耐受药物治疗的老年心房颤动患者，射频消融阻断房室传导同时植入永久性人工心脏起搏器能显著减轻症状，提高生活质量。. 【关键词】 心房颤动；导管消融；心脏起搏器，人工 effects of catheter ablation and pacemaker implantation on quality of life and ventricular function in patients ent，fuzhou general hospital,nanjing military mand,fuzhou,fujian,350025，chinaabstract：objective:to assess the effects of catheter ablation of the av conduction system and permanent pacemaker implantation on quality of life and cardiac structure and function in patients ptomatic atrial fibrillation（af）.methods:inpatients referred for catheter ablation of the av conduction system and permanent pacemaker implantation due to medically-refractory atrial fibrillation in the cardiovascular department of changzheng hospital ent in a prospective registry.baseline assessment prior to ablation included measurement of symptoms and quality of life easurement and echocardiography iarelated symptoms such as palpitations,dyspnea, dizziness and chest disfort arkedly improved （120%，104%，94%，25% respectively)as measured onths of folloeasurement revealed a significant reduction of ivstd［(11.6±2.3）mm vs.（9.1±1.4）mm］ ivsts［(17.1±5.1）mm vs.（11.8±1.2）mm］，lvpm vs.（9.1±1.4）mm］ and lvpm vs.（12.2±0.8）mm］,plt;0.05 all.the lvef in three patients receiving ddd pacemaker m vs.（34.0±6.4）mm,plt;0.01］ in 6 patients.conclusion:catheter ablation of atrioventricular junction and permanent pacemaker implantation are