不同起源部位频发室性期前收缩射频消融术对左心房结构及功能的影响

赵彦蕾; 张艳; 吴敬兰; 尹洪宁; 刘倩; 刘亚宁; 尤玲; 谢瑞芹

doi:10.13201/j.issn.1001-1439.2019.08.016

不同起源部位频发室性期前收缩射频消融术对左心房结构及功能的影响

- 1 河北医科大学第二医院心血管内一科(石家庄, 050000)

详细信息

通讯作者: 谢瑞芹, E-mail:13230178060@163.com

中图分类号: R541.7

收稿日期: 2019-03-20

The influence of left atrial structure and function after radiofrequency ablation of frequency prematuer contractions in different origins

- Department of Cardiology, The Second Hospital of Hebei Medical University, Shijiazhuang, 050000, China

More Information

Corresponding author: XIE Ruiqin, E-mail: 13230178060@163.com

Received Date: 20 March 2019

摘要

摘要: 目的:通过对比不同起源部位频发室性期前收缩 (室早) 射频消融术前及术后左心房结构及功能, 了解不同起源部位频发室早射频消融术对左心房的影响。方法:顺序收集2014-12-2017-09于我院住院, 动态心电图示室早负荷>10 000次/24h, 且成功行射频消融术患者123例。依据术中定位室早来源, 分为右室流出道游离壁24例, 右室流出道间隔部36例, 主动脉窦上36例, 主动脉窦下27例。入选患者应用心脏超声二维斑点追踪技术观察左心房结构及功能指标。结果: (1) 右室流出道游离壁来源组左心房直径 (LAD) 术前与对照组比较无显著差异;右室流出道间隔部、主动脉窦上、主动脉窦下来源组LAD术前较对照组显著增大。组间比较4组患者术后2周LAD下降至最低点, 以右室流出道间隔部减小最显著, 后依次为游离壁、主动脉窦上、主动脉窦下来源。 (2) 4组不同来源组左心房应变术前较对照组均显著降低;组间比较术后1个月左心房应变呈缓慢升高趋势并于术后1个月达最高点, 以右室流出道间隔部升高最显著, 后依次为游离壁、主动脉窦上、主动脉窦下来源。结论:频发室早可致LAD显著增大, 左心房应变显著降低, 经射频消融术后2周及1个月可逐渐改善, 尤以右室流出道间隔部改善最为显著, 后依次为游离壁、主动脉窦上、主动脉窦下来源。提示射频消融术对右室流出道间隔部、游离壁来源室早的治疗效果优于主动脉窦上及主动脉窦下来源。
- 频发室性期前收缩 /
- 不同起源部位 /
- 射频消融术 /
- 左心房结构及功能
Abstract: Objective:To compare the structure and function of left atrium before and after radiofrequency ablation in different origin sites.Method:There were 123 hospitalized patients with PVCs observed on 24-hour Holter monitoring (>10 000/24 h) in radiofrequency ablation surgery from December 2014 to September 2017.Among them 24 patients with PVCs originating in the free wall of the right ventricular outflow tract (age:43±18 years, 10 males) , 36 in the septum of the right ventricular out flow tract (age:44±11 years, 30 males) , 36 in the above-aortic sinus (age:43±15 years, 26 males) , 27 in the below-aortic sinus (age:47±12 years, 19 males) .The indices of left atrial structure and function were measured be echocardiography before and after radiofrequency ablation surgery at1 day, 2 weeks and 1 month.Result:LAD in the right ventricular outflow tract septum, superior aortic sinus and subaortic sinus origin group were significantly larger than that in the control group (33.7±3.7, 34.1±4.3, 35.1±4.8 vs 31.5±3.9, P<0.05) .The free wall of right ventricular outflow tract, septum, superior aortic sinus and subaortic sinus S were significantly lower before operation than in control group (37.2±17.7, 39.2±16.3, 32.4±17.9, 39.8±15.3 vs 52.1±17.8, P<0.05) .Conclusion:There was a significant increase in the diameter of the left atrium and a significant decrease in the left atrial strain, 2 and 4 weeks after radiofrequency ablation, especially in the septum of the right ventricular outflow tract, followed by the right ventricular outflow tract free wall, the aortic sinus and the aortic sinus.The results suggest that radiofrequency ablation is more effective in the treatment of septum of right ventricular outflow tract than that of superior aortic sinus or subaortic sinus.
- frequent ventricular premature beats /
- different origins /
- radiofrequency ablation /
- left atrial structure and function

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