Lelakowski Jacek, Dreher Adam, Majewski Jacek, Bednarek Jacek, Pasowicz Mieczysław
Klinika Elektrokardiologii Instytutu Kardiologii Collegium Medicum Uniwersytetu Jagiellońskiego w Krakowie, Krakowski Szpital Specjalistyczny im. Jana Pawła II.
Wiad Lek. 2009;62(2):71-80.
The purpose of the present study was to evaluate the effects of RF ablation on parameters of left ventricular (LV) function and exercise capacity in patients with AVRT.
The study population consisted of 24 subjects (10M, 14F), mean age 38.1+/-8.9 years. Subjects over 50 years of age, with concomitant cardiovascular disease and EF<50% were excluded from the study. The following examinations were performed in all patients at baseline and at six months after the procedure: 1) physical examination, 2) standard ECG recording, 3) 24hr Holter monitoring, 4) transthoracic ECHO, 5) treadmill exercise test using the modified Bruce protocol to evaluate exercise duration, peak heart rate and workload achieved.
After RF ablation NYHA functional class improved in the whole population. The left ventricular dimensions (LVESD, LVEDD), left ventricular ejection fraction (LVEF), fractional shortening (FS) in AVRT group remained unchanged. Parameters of LV diastolic function significantly improved, whereas systolic pulmonary venous flow S and pulmonary venous atrial reversal flow AR were significantly reduced (p<0.005, p<0.001, respectively). All dimensions of the left atrium significantly decreased after the procedure (p<0.001). In all patients parameters of exercise capacity were increased after the procedure.
In patients with AVRT RF ablation did not affect significantly left ventricular dimensions and systolic function. Elimination of AVRT resulted in improved NYHA functionalclass, diastolic LV function, exercise capacity and reduction of left atrial size.
本研究的目的是评估射频消融术对房室折返性心动过速(AVRT)患者左心室(LV)功能参数和运动能力的影响。
研究人群包括24名受试者(10名男性,14名女性),平均年龄38.1±8.9岁。年龄超过50岁、伴有心血管疾病且射血分数(EF)<50%的受试者被排除在研究之外。所有患者在基线时和手术后六个月进行了以下检查:1)体格检查,2)标准心电图记录,3)24小时动态心电图监测,4)经胸超声心动图,5)使用改良布鲁斯方案的跑步机运动试验,以评估运动持续时间、峰值心率和达到的工作量。
射频消融术后,整个人群的纽约心脏协会(NYHA)功能分级得到改善。AVRT组的左心室尺寸(左心室收缩末期内径、左心室舒张末期内径)、左心室射血分数(LVEF)、缩短分数(FS)保持不变。左心室舒张功能参数显著改善,而收缩期肺静脉血流S和肺静脉心房逆向血流AR显著降低(分别为p<0.005,p<0.001)。手术后左心房的所有尺寸均显著减小(p<0.001)。所有患者术后运动能力参数均增加。
对于AVRT患者,射频消融术对左心室尺寸和收缩功能无显著影响。消除AVRT可改善NYHA功能分级、左心室舒张功能、运动能力并减小左心房大小。