Scherer Mirela, Therapidis Panagiotis, Wittlinger Thomas, Miskovic Aleksandra, Moritz Anton
Department of Thoracic and Cardiovascular Surgery, J. W. Goethe University, Frankfurt/Main, Germany.
J Heart Valve Dis. 2007 Mar;16(2):126-31.
The study aim was to evaluate the efficacy of left atrial (LA) size reduction combined with radiofrequency (RF) ablation in the treatment of continuous atrial fibrillation (AF), by comparative analysis of the outcomes of patients undergoing RF ablation with and without LA size reduction.
A total of 46 patients with continuous AF and cardiac disease underwent cardiac surgery and RF ablation alone (group I, n = 20) or combined with LA size reduction (group II, n = 26). Patients were followed for three years postoperatively, with evaluation of cardiac rhythm, neurological complications, LA size (by echocardiography) and atrial contractility.
At three years after surgery, sinus rhythm (SR) was restored in 61.1% and 70% of patients in groups I and II, respectively. Mean LA diameter was reduced from 60 +/- 15 mm to 57 +/- 5 mm in group I, and from 69 +/- 19 mm to 55 +/- 6 mm in group II. The overall three-year survival was 90% in group I, and 88.5% in group II. Three-year freedom from stroke was 88.9% and 86.2% in groups I and II, respectively. Two patients in each group received transvenous permanent pacemaker implantation. Atrial contractility was recovered in all patients with stable SR.
LA size reduction improves SR conversion rate after RF ablation for continuous AF in patients undergoing concomitant cardiac surgery.
本研究旨在通过对比分析接受射频消融术（有或无左心房容积减小）患者的治疗结果，评估左心房（LA）容积减小联合射频消融术治疗持续性心房颤动（AF）的疗效。
共有46例患有持续性AF和心脏病的患者接受了心脏手术，其中单独接受射频消融术的患者为I组（n = 20），联合左心房容积减小的患者为II组（n = 26）。术后对患者进行了三年随访，评估心律、神经并发症、左心房容积（通过超声心动图）和心房收缩功能。
术后三年，I组和II组分别有61.1%和70%的患者恢复窦性心律（SR）。I组的平均左心房直径从60±15mm降至57±5mm，II组从69±19mm降至55±6mm。I组的三年总生存率为90%，II组为88.5%。I组和II组的三年无卒中生存率分别为88.9%和86.2%。每组各有两名患者接受了经静脉永久起搏器植入术。所有恢复稳定SR的患者心房收缩功能均得以恢复。
对于同时接受心脏手术的持续性AF患者，左心房容积减小可提高射频消融术后的SR转化率。
