Mamchur Sergey E, Mamchur Irina N, Khomenko Egor A, Bokhan Nikita S, Scherbinina Diana A
Interv Med Appl Sci. 2014 Mar;6(1):31-9. doi: 10.1556/IMAS.6.2014.1.5. Epub 2014 Mar 14.
The aim of the study was to compare the efficacy of pulmonary vein antrum isolation (PVAI), extended PVAI and ganglionic plexi (GP) ablation in persistent AF.
One hundred and twenty patients 56.2 ± 8.8 years old were randomized into three groups: GP ablation (n = 37), PVAI (n = 42), and extended PVAI (n = 41). The following parameters were studied: sinus rhythm restoration, vagal reactions, fluoroscopy time, procedure duration, lesion surface area. In 16 months after the procedure, echocardiography and Holter monitoring were performed.
Significant differences were found in the amount of X-ray exposure, procedure duration, lesion surface area and vagal reactions. In all the cases, atrial mechanical function worsened after the procedure. However, there were no significant differences between the groups. Sixteen months after the procedure, sinus rhythm without antiarrhythmic therapy was maintained in 38% of patients in GP group, in 56% of patients in PVAI group and in 69% of patients in extended PVAI group.
In persistent AF, the extended PVAI is more effective than PVAI and GP ablation. After the PVAI or extended PVAI, abnormalities of the left atrial mechanical function occurred if the lesion area exceeded 25% of the total LA surface area.
本研究的目的是比较肺静脉前庭隔离术（PVAI）、扩展PVAI和神经节丛（GP）消融术在持续性房颤中的疗效。
120例年龄为56.2±8.8岁的患者被随机分为三组：GP消融组（n = 37）、PVAI组（n = 42）和扩展PVAI组（n = 41）。研究了以下参数：窦性心律恢复情况、迷走神经反应、透视时间、手术持续时间、病变表面积。术后16个月，进行超声心动图和动态心电图监测。
在X线暴露量、手术持续时间、病变表面积和迷走神经反应方面发现了显著差异。在所有病例中，术后心房机械功能均恶化。然而，各组之间无显著差异。术后16个月，GP组38%的患者、PVAI组56%的患者和扩展PVAI组69%的患者在未使用抗心律失常治疗的情况下维持窦性心律。
在持续性房颤中，扩展PVAI比PVAI和GP消融更有效。在PVAI或扩展PVAI术后，如果病变面积超过左心房总面积的25%，则会出现左心房机械功能异常。
