Arrhythmia Department, State Research Institute of Circulation Pathology, Novosibirsk, Russia.
Europace. 2010 Mar;12(3):342-6. doi: 10.1093/europace/euq014.
To study the potential efficacy of ganglionated plexi (GP) ablation in the setting of longstanding persistent atrial fibrillation (AF).
Anatomic ablation at the areas of GP in the left atrium was performed in 89 patients with symptomatic, drug-refractory, persistent AF (71 men, 56 +/- 7 years of age). In 29 patients, a second procedure by means of circumferential pulmonary vein (PV) isolation was performed, and 5 of them were subjected to a third circumferential ablation. At 16 +/- 7 months after the final ablation procedure, 53 (59.6%) of the 89 patients were in sinus rhythm in the absence of antiarrhythmic drug therapy, 5 (5.6%) patients had permanent AF, and 31 (34.8%) patients had paroxysmal AF. The long-term success rate for patients who underwent a single ablation procedure with only GP ablation was 38.2% over a follow-up of 24 +/- 3 months. Independent predictors of later arrhythmia recurrences were left atrial diameter [HR 1.039 (1.00-1.07), P = 0.028] and duration of AF prior to ablation [HR 1.116 (1.02-1.22), P = 0.008].
Ganglionated plexi ablation in chronic AF results in long-term maintenance of sinus rhythm in 38.2% of cases. Repeat procedures with circumferential isolation of all PV offer a success rate of 59.6% over a follow-up of 16 +/- 7 months.
研究在慢性持续性房颤（AF）患者中，对神经节丛（GP）进行消融的潜在疗效。
对 89 例有症状、药物难治性、持续性 AF（71 名男性，56±7 岁）患者的左心房 GP 区域进行解剖消融。在 29 例患者中，通过环形肺静脉（PV）隔离进行了第二次手术，其中 5 例患者接受了第三次环形消融。在最后一次消融手术后 16±7 个月，89 例患者中有 53 例（59.6%）在未使用抗心律失常药物治疗的情况下处于窦性心律，5 例（5.6%）患者发生永久性 AF，31 例（34.8%）患者发生阵发性 AF。仅行 GP 消融的单次消融术患者的长期成功率为 38.2%，随访时间为 24±3 个月。心律失常复发的独立预测因素是左心房直径[HR 1.039（1.00-1.07），P=0.028]和消融前 AF 的持续时间[HR 1.116（1.02-1.22），P=0.008]。
在慢性 AF 中进行神经节丛消融可使 38.2%的患者长期维持窦性心律。对所有 PV 进行环形隔离的重复手术，在 16±7 个月的随访中成功率为 59.6%。
