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目的:分析环肺静脉消融治疗老年患者心房颤动的有效性和安全性,并分析其术后复发危险因素。方法:通过多中心临床注册研究的方式分析全国2006年1-12月460例行环肺静脉消融治疗老年房颤患者(年龄≥60岁)的有效病例资料,观察手术的成功率、复发率和并发症发生情况,并分析其复发危险因素。结果:在平均(9.0±3.7)月的随访期间,环肺静脉消融治疗老年患者心房颤动的成功率为75.9%,复发率为24.1%。阵发性房颤、持续性房颤和永久性房颤成功率分别为77.1%、69.4%和55.6%。消融总的并发症发生率为3.0%,其中心包压塞7例(1.5%),皮下血肿5例(1.1%),感染1例(0.2%),脑卒中1例(0.2%)。术前左房内径增大是消融后房颤复发的危险因素(P<0.01)。结论:环肺静脉消融治疗老年患者心房颤动具有较好的有效性和安全性,术前左房内径增大是消融后房颤复发的危险因素。
OBJECTIVE: To analyze the effectiveness and safety of circumferential pulmonary vein ablation for the treatment of atrial fibrillation in elderly patients and to analyze the risk factors of postoperative recurrence. Methods: From April 2006 to January 2006, 460 cases of elderly patients with atrial fibrillation (≥60 years of age) undergoing circumferential pulmonary vein ablation were analyzed retrospectively. The successful rate, recurrence rate and concurrent The incidence of the disease, and analyze the risk of relapse. RESULTS: During a mean follow-up of 9.0 ± 3.7 months, the success rate of circumferential pulmonary vein ablation in elderly patients with atrial fibrillation was 75.9% and the recurrence rate was 24.1%. The success rates of paroxysmal atrial fibrillation, persistent atrial fibrillation and permanent atrial fibrillation were 77.1%, 69.4% and 55.6% respectively. The total incidence of ablation was 3.0%. There were 7 cases (1.5%) of tamponade, 5 cases of subcutaneous hematoma (1.1%), 1 case of infection (0.2%) and 1 case of stroke (0.2%). Preoperative left atrial diameter increased after ablation is a risk factor for recurrence of atrial fibrillation (P <0.01). CONCLUSION: Circumferential pulmonary vein ablation is effective and safe for the treatment of atrial fibrillation in elderly patients. The preoperative increase of left atrium diameter is a risk factor for AF recurrence after ablation.