刘兴鹏，马长生，董建增，刘旭，王建安，王健，郭成军，方冬平.应用超声能量行肺静脉电学隔离的即刻效果及其影响因素[J].中华物理医学与康复杂志,2003,(12):.-
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| 应用超声能量行肺静脉电学隔离的即刻效果及其影响因素 |
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| DOI： |
| 中文关键词: 超声能量 心房颤动 肺静脉 消融 |
| 英文关键词: Ultrasound energy Atrial fibrillation Pulmonary vein Ablation |
| 基金项目:北京市科技新星计划资助项目（No．H013610150113） |
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| 摘要点击次数: 2027 |
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| 中文摘要: |
| 目的探索应用超声能量行心房颤动（房颤）肺静脉电学隔离治疗的即刻效果，并分析其影响因素。 方法选择39例接受肺静脉超声球囊消融的阵发性房颤患者，根据消融温度的不同分为低温消融组（22例）和高温消融组（17例），前者消融时预设温度为50~55℃，后者为60~65℃。两组的消融部位均位于肺静脉开口部，消融终点为肺静脉电学隔离。比较两组肺静脉电学隔离率，并分析影响消融效果的解剖因素。 结果总计消融115根肺静脉，其中78根（67.8%）达到消融终点。高温消融组的肺静脉电学隔离率（78％）显著高于低温消融组（60%）（P<0.05）。影响肺静脉电学隔离效果的解剖因素主要包括：漏斗状肺静脉开口、肺静脉开口异常扩张、肺静脉主干与左房顶部平行等。 结论现阶段应用超声能量行肺静脉电学隔离的即刻效果可以接受，影响消融效果的主要因素是消融温度和受治肺静脉的解剖学特征。 |
| 英文摘要: |
| Objective To explore the immediate efficacy of electrical isolation of pulmonary veins (PVs) with ultrasound energy in patients with atrial fibrillation and its influential factors. MethodsCircumferential ablation of the ostium of the PVs using an ultrasound balloon system were performed in 39 patients with paroxysmal atrial fibrillation. The endpoint of the procedure was PVs electrical isolation. All patients were divided into two groups according to ablation temperature: higher ablation temperature group ablated with a temperature 60~65℃ and lower ablation temperature group performed with a temperature 50~55℃. The rate of PVs isolation of two groups was compared and the anatomic factors of PVs related to ineffective ablation were analyzed. ResultsA total of 115 PVs were ablated, and 78 (67.8%) of them achieved the endpoint. The rate of PVs isolation in the higher ablation temperature group (78%) was significantly higher than that in the lower ablation temperature group (60%, P<0.05). The anatomic characteristics of PVs identified as possible reasons for ineffective ablation were funnel-shaped PV ostium, extremely dilation of PV ostium, and the trunk of PV parallel to the roof of left atrium. ConclusionUltrasound energy can isolate PVs with an acceptable effective rate. Characteristics of PVs anatomy and temperature of ablation were the factors contributed to the immediate effect of PVs ultrasound ablation. |
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