心衰合并房颤患者的射频消融治疗2015课件.pptVIP

入院心电图 AT 有时有 Af 上次住院及此次住院心脏彩超：LVEF 27%,33%,LA 43-45mm 心衰稍稳定后，食道超声证实左房无血栓后，在CARTO 3引导下进行消融术，自行恢复窦律。 2C3L方案进行消融 消融后3周及半年复查心脏超声提示LVEF 46%，50%，LA 36mm,34mm 总结 人口的老龄化，临床心衰合并房颤的患者越来越多； 心衰合并房颤互为因果，恶性循环，增加不良预后； 射频消融是部分心衰合并房颤患者重要而有效的治疗手段； 消融方式应根据病情在肺静脉隔离基础上加用线性消融、碎裂电位以及转子消融等； 射频消融可有效维持窦律，改善患者左室收缩功能，提高生活质量，增加运动耐量。 Framingham Heart Study. 左. Unadjusted cumulative incidence of first CHF in individuals with AF. 右. Unadjusted cumulative incidence of first AF in individuals with CHF. * Framingham Heart Study Impact of Developing the Comorbid Condition on Mortality We used multivariable models to evaluate the impact of CHF on mortality in AF subjects, restricting our analyses to those who were free of CHF at the time of AF diagnosis (Table 2). The subsequent development of CHF (time-dependent variable) was associated with a multivariable-adjusted hazard ratio for mortality of 2.7 (95% CI, 1.9 to 3.7) in men and 3.1 (95% CI, 2.2 to 4.2) in women. Similarly, we examined the impact of AF on mortality in CHF subjects, restricting our analyses to those who were free of AF at the time of CHF diagnosis (Table 2). The development of subsequent AF (time-dependent variable) was associated with an adjusted hazard ratio for mortality of 1.6 (95% CI, 1.2 to 2.1) in men and 2.7 (95% CI, 2.0 to 3.6) in women. HFSIS 以色列心衰住院患者房颤及对预后影响的研究 Aims Atrial fibrillation (AF) and heart failure (HF) commonly coexist, and each adversely affects the other. The aim of the study was to prospectively evaluate the impact of AF and its subtypes on management, and early and long-term outcome of hospitalized HF patients. Methods and results Data were prospectively collected on HF patients hospitalized in all public hospitals in Israel as part of a national survey (HFSIS). Atrial fibrillation patients were subdivided into intermittent and chronic AF subgroups. During March–April 2003, we enrolled 4102 HF patients, of whom 1360 (33.2%) had AF [600 (44.1%) intermittent, 562 (41.3%) chronic]. Patients with AF wer