Wang Jian-gang, Meng Xu, Han Jie, Li Yan, Xu Chun-lei, Luo Tian-ge, Wang Jun, Cui Yong-qiang
Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China.
Zhonghua Wai Ke Za Zhi. 2010 Oct 15;48(20):1561-4.
To evaluate the effectiveness of the video-assisted minimally invasive radiofrequency ablation combined irbesartan use for the treatment of the persistent atrial fibrillation (AF).
From January 2006 to December 2009, 83 patients with persistent AF having a video-assisted minimally invasive radiofrequency ablation. There were 58 males, 25 females with a mean age of (57 ± 11) years. Mean duration of preoperative AF was (61 ± 65) months. Follow-up for the whole patients ranged from 1.0 to 3.6 years [mean (2.2 ± 0.8) years]. Patients were randomly divided into irbesartan group (n = 42) and without irbesartan group (n = 41) postoperatively.
No patient died postoperatively. During follow-up, there was 1 patient died of unknown reason. At the end of the procedure, 38 patients (45.7%) were sinus rhythm, 4 patients (4.9%) were pacing rhythm, 5 patients (6.0%) were atrial flutter or atrial tachycardia, and 36 patients (43.4%) were AF. Before discharge, 53 patients (63.9%) were sinus rhythm, 24 patients (28.9%) were AF. At late follow-up, 65 patients (80.2%) were sinus rhythm; 14 patients (17.3%) were AF or atrial flutter. After follow-up, the Kaplan-Meier analysis showed the irbesartan group had fewer patients with AF (P = 0.020). The hazard ratio for AF recurrence in patients treated with irbesartan was 0.24 (95% CI: 0.087 to 0.637, P = 0.004).
The video-assisted minimally invasive radiofrequency ablation is safe and effective. The patients treated with irbesartan have a lower rate of recurrence of AF.
评估电视辅助微创射频消融联合使用厄贝沙坦治疗持续性心房颤动（房颤）的有效性。
2006年1月至2009年12月，83例持续性房颤患者接受电视辅助微创射频消融治疗。其中男性58例，女性25例，平均年龄（57±11）岁。术前房颤平均持续时间为（61±65）个月。所有患者随访时间为1.0至3.6年[平均（2.2±0.8）年]。术后患者随机分为厄贝沙坦组（n = 42）和非厄贝沙坦组（n = 41）。
术后无患者死亡。随访期间，有1例患者死于不明原因。手术结束时，38例患者（45.7%）为窦性心律，4例患者（4.9%）为起搏心律，5例患者（6.0%）为心房扑动或房性心动过速，36例患者（43.4%）为房颤。出院前，53例患者（63.9%）为窦性心律，24例患者（28.9%）为房颤。随访后期，65例患者（80.2%）为窦性心律；14例患者（17.3%）为房颤或心房扑动。随访后，Kaplan-Meier分析显示厄贝沙坦组房颤患者较少（P = 0.020）。接受厄贝沙坦治疗的患者房颤复发的风险比为0.24（95%CI：0.087至0.637，P = 0.004）。
电视辅助微创射频消融安全有效。接受厄贝沙坦治疗的患者房颤复发率较低。
