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环肺静脉电隔离加心房线性消融治疗持续性心房颤动多中心临床研究

Multi-center clinical trial of circumferential pulmonary vein isolation plus linear lesion for persistent atrial fibrillation

摘要:

目的 评价环肺静脉电隔离加心房线性消融治疗持续性心房颤动(房颤)的有效性和安全性.方法 入选481例经导管射频消融治疗房颤的多中心临床注册研究(AFCT研究)的持续性房颤患者,分单一环肺静脉电隔离组(CPVI组,205例)和环肺静脉电隔离加心房线性消融组(CPVI+ LL组,276例).分析比较两组手术时间、X线曝光时间、消融时间、并发症发生率以及术后3、6和12个月的成功率.结果 CPVI+ LL组手术时间[(239.0±56.6)min对(159.3±51.5) min,P<0.01]和消融时间[(94.8±22.5)min对(60.2±16.6)min,P<0.01]明显长于CPVI组,但两组X线曝光时间差异无统计学意义[(47.5±18.2)min对(52.4±21.6) min,P>0.05].两组围术期并发症发生率差异无统计学意义(0.72%对0.98%,P>0.05).两组术后3和6个月成功率无明显差异,但CPVI+LL组术后12个月的成功率明显高于CPVI组(74.2%对62.1%,P<0.05).结论 CPVI基础上增加心房辅助径线消融对持续性房颤是必要的,可增加持续性房颤中长期成功率.

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abstracts:

Objective To investigate the safety and efficacy of circumferential pulmonary vein isolation (CPVI) plus linear lesion in patients with persistent atrial fibrillation (AF).Methods This study included 481 patients registered in the Atrial Fibrillation Clinical Trial (AFCT) in China.All patients had persistentAF and received CPVI (CPVI group,n =205) or CPVI plus linear lesion (CPVI+LL group,n =276).The total time of the procedure,time of fluoroscopy,time of radiofrequency applications,complications incidence and success rate at 3,6,12-month follow-up were compared.Results The total time of the procedure and time of radiofrequency applications in CPVI+LL group were significantly longer than that in CPVI group[(239.0±56.6)min vs (159.3±51.5) min,P<0.01 ; (94.8 ±22.5) min vs (60.2± 16.6) min,P<0.01],but the time of fluoroscopy had no significant difference between two groups[(47.5±18.2) min vs(52.4±21.6) min,P>0.05].In addition,there was no significant difference in the complications incidence between two groups (0.72% vs 0.98%,P>0.05).The success rate at 3-month and 6-month follow-up had no significant difference between two groups,but CPVI+LL group achieved a significant higher success rate than CPVI group at 12-month followup (74.2% vs 62.1%,P<0.05).Conclusion For persistent AF,CPVI plus linear lesion is necessary,which can increase the long-term success rate.

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作者: 刘育 [1] 黄鹤 [1] 吴钢 [1] 袁明杰 [1] 唐艳红 [1] 王晞 [1] 黄从新 [1]
第一作者: 刘育
栏目名称: 临床研究
DOI: 10.3760/cma.j.issn.1007-6638.2013.01.010
发布时间: 2013-04-26
基金项目:
卫生公益性行业科研专项经费 国家十二五科技支撑计划 武汉市科技攻关项目
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