左房容积指数在射频消融术患者中的临床意义(1)
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[摘要]目的 评价射频消融术(RFCA)治疗房颤患者后左房容积指数(LAVI)的变化，及讨论LAVI对RFCA后房颤复发的预测价值。方法 选择住院接受RFCA治疗的房颤患者68例，观察患者治疗前后心脏结构的变化，并分析RFCA后房颤复发的影响因素。结果 RFCA患者治疗后1年后复查LAVI明显减低，LAVI与房颤复发独立相关。结论 RFCA治疗有助于心肌结构的改善，LAVI可用于预测RFCA后心房颤动的复发率。
[关键词] 心房颤动；射频消融；左房容积指数
[中图分类号] R541.7 [文献标识码] B [文章编号] 1673-9701(2011)32-52-02
The Clinical Significance of Left Atrial Volume Index in Radiofrequency Catheter Ablation in Patients
SHEN Xuping ZHAI Changlin
Department of Cardiac Ultrasound Room，the First People's Hospital of Tongxiang City in Zhejiang Province，Tongxiang 314500，China
[Abstract] Objective To evalue the radiofrequency catheter ablation treatment of atrial fibrillation in patients with left atrial volume index changes，and disscuss the predictive value of left atrial volume index in radiofrequency ablation of atrial fibrillation recurrence.Methods All 68 patients undergoing radiofrequency ablation in patients with atrial fibrillation were observed the changes of heart structure before and after treatment， and examined the radiofrequency catheter ablation of atrial fibrillation recurrence after influence factors. Results Left atrial volume index in the treatment of patients after 1 years after Radiofrequency ablation was significantly lower， and left atrial volume index was related with the recurrence of atrial fibrillation independently. Conclusion Radiofrequency ablation therapy contributes to myocardial structure improvement，and left atrial volume index can be used to predict the atrial fibrillation recurrence rateafter radiofrequency catheter ablation treatment.
[Key words] Atrial fibrillation；Radiofrequency ablation；Left atrial volume index
心房颤动简称房颤，为较常见的心律失常。据统计60岁以上的人群中发病率为1%，并随年龄的增长而增加。目前射频消融术(radiofrequency Ablation，RFCA)已成为房颤治疗的一线手段，可以明显缓解症状，改善预后，但其复发率较高。国内有关左房容积指数(left atrial volume index，LAVI)对RFCA后的房颤患者复发的预测价值报道甚少。
1 资料与方法
1.1 一般资料
选择2008年1月～2009年6月在上海中山医院进修时收集的房颤患者68例，其中男36例、女32例。入选标准：所有患者均为因抗心律失常药物治疗无效或不愿意接受药物治疗的房颤患者；均经食管内超生或胸部CT证实无心房内血栓；均排除既往有RFCA史、预激综合征伴房颤、风湿性心脏病伴房颤、甲亢、严重心力衰竭、出血病史。
1.2 治疗方法
(1)心脏电生理：常规利多卡因局麻下穿刺左侧颈内静脉及左侧股静脉，分别放置导管致冠状静脉窦及右室心尖区；放置SWARTZ长鞘行房间隔穿刺术 ......
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