Yu Bo, Li Yang, Zhao Wei-hua, Pang Xue-feng, Tian Wen, Hu Jian, Qi Guo-xian, Li Min
Department of Cardiology, No.1 Hospital, China Medical University, Shenyang 110001, China.
Zhonghua Yi Xue Za Zhi. 2006 Jun 27;86(24):1714-7.
To evaluate the clinical effects of different catheter ablation strategies in the treatment of typical atrial flutter complicated with paroxysmal atrial fibrillation (PAF). [CTIA, pulmonary vein segmental isolation (PVSI), CTIA + PVI] to the patients coexisted with typical atrial flutter and PAF.
66 patients with typical atrial flutter complicated with PAF were divided into 3 groups: Group A (n = 30), undergoing cavotricuspid isthmus ablation, (CTIA), Group B (n = 17), undergoing pulmonary vein segmental isolation, (PVSI), and Group C (n = 19), undergoing CTIA + PVSI. Follow-up was conducted for 30.5 weeks +/- 10.4 weeks. The clinical curative effects, operation safety, and complication were evaluated.
The recurrence rate of typical atrial flutter within 12 weeks after operation of Groups A and C were 13.3% and 10.5% respectively, both significantly lower than that of Group B (52.9%, both P < 0.05) without no significant difference between Group A and Group C (P > 0.05). The recurrence rate of typical atrial flutter within 36 weeks after operation of the Groups A, B, and C were 10%, 11.8%, and 10.5% respectively, without significant differences among these 3 groups (all P > 0.05). The recurrence rates of PAF within 12 weeks and 30 weeks after operation of Groups B and C were 29.4% and 31.6%, and 23.5% and 26.3% respectively, all significantly lower than those of Group A (46.7% and 73.3% respectively, all P < 0.05) without significant o differences between Groups B and C.
In patients with both typical atrial flutter and PAF, pure CTIA has a good effect on typical atrial flutter, whereas the PAF recurrence rate is higher; Pure PVSI has a good control of typical atrial flutter while curing PAF; PVSI + CTIA only reduces the early recurrence of typical atrial flutter, however, has no advantage in long-term follow up.
评估不同导管消融策略治疗典型心房扑动合并阵发性心房颤动（PAF）的临床效果。[三尖瓣峡部消融（CTIA）、肺静脉节段隔离（PVSI）、CTIA + 肺静脉隔离（PVI）]应用于典型心房扑动和PAF并存的患者。
66例典型心房扑动合并PAF患者分为3组：A组（n = 30），接受三尖瓣峡部消融（CTIA）；B组（n = 17），接受肺静脉节段隔离（PVSI）；C组（n = 19），接受CTIA + PVSI。随访30.5周±10.4周。评估临床疗效、手术安全性及并发症。
A组和C组术后12周内典型心房扑动复发率分别为13.3%和10.5%，均显著低于B组（52.9%，均P < 0.05），A组与C组之间无显著差异（P > 0.05）。A、B、C组术后36周内典型心房扑动复发率分别为10%、11.8%和10.5%，3组间无显著差异（均P > 0.05）。B组和C组术后12周和30周PAF复发率分别为29.4%和31.6%，以及23.5%和26.3%，均显著低于A组（分别为46.7%和73.3%，均P < 0.05），B组和C组之间无显著差异。
对于典型心房扑动和PAF并存的患者，单纯CTIA对典型心房扑动效果良好，但PAF复发率较高；单纯PVSI对典型心房扑动控制良好且能治愈PAF；PVSI + CTIA仅降低典型心房扑动的早期复发率，然而在长期随访中无优势。
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