• 中山大學(xué)附屬第一醫(yī)院心臟外科，廣州 510080;

目的 　了解外科雙極射頻消融術(shù)治療永久性心房顫動（ AF）同期行風濕性心臟病瓣膜置換術(shù)的效果。方法 　自 2006年 3月至 2010年 10月中山大學(xué)附屬第一醫(yī)院收治風濕性心瓣膜病合并心房顫動患者 124例，按照拋硬幣法隨機分成射頻消融組（ n=62）和對照組（ n=62），比較兩組患者的臨床資料、體外循環(huán)（CPB）時間、主動脈阻斷（ACC）時間、術(shù)后機械通氣時間、 ICU治療情況、并發(fā)癥及隨訪結(jié)果。結(jié)果 　兩組患者臨床資料比較差異無統(tǒng)計學(xué)意義（ P＞0.05）。射頻消融組患者術(shù)后住院時間較對照組長［（15.8±6.1）d vs.（12.9±3.1）d，P=0.001］, CPB和 ACC時間兩組間比較差異無統(tǒng)計學(xué)意義（ P＞0.05）。兩組患者均無需放置永久起搏器，術(shù)后左心室射血分數(shù)（LVEF）兩組比較差異有統(tǒng)計學(xué)意義（ 59.6%±9.2% vs. 55.5%±5.4%，P＜0.01）。在 6個月、12個月、18個月和 24個月隨訪時射頻消融組竇性心律維持率分別為 88.5%、87.5%、87.1%和 82.4%，對照組分別為 3.3%、2.2%、0.0%和 0.0%，兩組比較差異有統(tǒng)計學(xué)意義（ P＜ 0.05）。結(jié)論　 外科雙極射頻消融術(shù)能有效治療永久性心房顫動。

引用本文： 楊嵩,張希,唐白云等. 永久性心房顫動外科雙極射頻消融術(shù)的效果. 中國胸心血管外科臨床雜志, 2012, 19(3): 254-257. doi: 復(fù)制

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2. 　Lloyd-Jones DM, Wang TJ, Leip EP, et al. Lifetime risk for development of atrial ?brillation： the framingham heart study. Circulation, 2004, 110 （9） ：1042-1046.
3. 　Hu D, Sun Y. Epidemiology, risk factors for stroke, and management of atrial fibrillation in China. J Am Coll Cardiol, 2008, 52 （10）： 865-868.
4. 　Prasad SM, Maniar HS, Schuessler RB, et al. Chronic transmural atrial ablation by using bipolar radiofrequency energy on the beating heart. J Thorac Cardiovasc Surg , 2002 , 124 （4）：708-713.
5. 　Prasad SM, Maniar HS, Diodato MD, et al. Physiological consequences of bipolar radiofrequency energy on the atria and pulmonary veins： a chronic animal study. Ann Thorac Surg, 2003, 76 （3）：.
6. 　Calkins H, Brugada J, Packer DL, et al. HRS/EHRA/ECAS expert consensus statement on catheter and surgical ablation of atrial fibrillation： recommendations for personnel, policy, procedures and follow-up. Europace, 2007, 9（6）： 335-379.
7. 　Abreu Filho CA, Lisboa LA, Dallan LA, et al. Effectiveness of the maze procedure using cooled-tip radiofrequency ablation in patients with permanent atrial fibrillation and rheumatic mitral valve disease.Circulation, 2005, 112 （9 Suppl）：I20-I25.
8. 　Wang W, Guo LR, Martland AM, et al. Biatrial reduction plasty with reef imbricate technique as an adjunct to maze procedure for permanent atrial fibrillation associated with giant left atria. Interact Cardiovascular Thorac Surg, 2010, 10 （4）： 577-581.
9. 　Melby SJ, Zierer A, Bailey MS, et al. A new era in the surgical treatment of atrial fibrillation： the impact of ablation technology and lesion set on procedural efficacy. Ann Surg , 2006, 244 （4）：.
10. 　Oral H, Knight BP, Ozaydin M, et al. Clinical significance of early recurrences of atrial fibrillation after pulmonary vein isolation. J Am Coll Cardiol , 2002, 40 （1）：100-104.
11. 　Tekumit H, Uzun K, Cenal AR，et al. Midterm results of left atrial bipolar radiofrequency ablation combined with a mitral valve procedure in persistent atrial fibrillation. Cardiovasc J Afr, 2010, 21（3）：137-141.
12. 　Sternik L, Luria D, Glikson M, et al. Efficacy of surgical ablation of atrial fibrillation in patients with rheumatic heart disease. Ann Thorac Surg , 2010, 89（5）：1437-1442.
13. 　Okada M, Usui A, Sakurai T, et al. Comparative study between cryoablation and radiofrequency ablation for surgical intervention of atrial fibrillation associated with mitral valve disease. Kyobu Geka, 2010, 63（4）：297-302.
14. 　Santarpino G, Rubino AS, Onorati F, et al. Atrial fibrillation ablation induces reverse remodelling and impacts cardiac function. Minerva Cardioangiol, 2011, 59（1）：17-29.
15. -592.
16. -841.
  1. 1. 　Thom T, Haase N, Rosamond W, et al. Heart disease and stroke statistics–2006 update： a report from the American Heart Association Atatistics Committee and Stroke Statistics Subcommittee. Circulation, 2006, 113 （6）： e85-e151.
  2. 2. 　Lloyd-Jones DM, Wang TJ, Leip EP, et al. Lifetime risk for development of atrial ?brillation： the framingham heart study. Circulation, 2004, 110 （9） ：1042-1046.
  3. 3. 　Hu D, Sun Y. Epidemiology, risk factors for stroke, and management of atrial fibrillation in China. J Am Coll Cardiol, 2008, 52 （10）： 865-868.
  4. 4. 　Prasad SM, Maniar HS, Schuessler RB, et al. Chronic transmural atrial ablation by using bipolar radiofrequency energy on the beating heart. J Thorac Cardiovasc Surg , 2002 , 124 （4）：708-713.
  5. 5. 　Prasad SM, Maniar HS, Diodato MD, et al. Physiological consequences of bipolar radiofrequency energy on the atria and pulmonary veins： a chronic animal study. Ann Thorac Surg, 2003, 76 （3）：.
  6. 6. 　Calkins H, Brugada J, Packer DL, et al. HRS/EHRA/ECAS expert consensus statement on catheter and surgical ablation of atrial fibrillation： recommendations for personnel, policy, procedures and follow-up. Europace, 2007, 9（6）： 335-379.
  7. 7. 　Abreu Filho CA, Lisboa LA, Dallan LA, et al. Effectiveness of the maze procedure using cooled-tip radiofrequency ablation in patients with permanent atrial fibrillation and rheumatic mitral valve disease.Circulation, 2005, 112 （9 Suppl）：I20-I25.
  8. 8. 　Wang W, Guo LR, Martland AM, et al. Biatrial reduction plasty with reef imbricate technique as an adjunct to maze procedure for permanent atrial fibrillation associated with giant left atria. Interact Cardiovascular Thorac Surg, 2010, 10 （4）： 577-581.
  9. 9. 　Melby SJ, Zierer A, Bailey MS, et al. A new era in the surgical treatment of atrial fibrillation： the impact of ablation technology and lesion set on procedural efficacy. Ann Surg , 2006, 244 （4）：.
  10. 10. 　Oral H, Knight BP, Ozaydin M, et al. Clinical significance of early recurrences of atrial fibrillation after pulmonary vein isolation. J Am Coll Cardiol , 2002, 40 （1）：100-104.
  11. 11. 　Tekumit H, Uzun K, Cenal AR，et al. Midterm results of left atrial bipolar radiofrequency ablation combined with a mitral valve procedure in persistent atrial fibrillation. Cardiovasc J Afr, 2010, 21（3）：137-141.
  12. 12. 　Sternik L, Luria D, Glikson M, et al. Efficacy of surgical ablation of atrial fibrillation in patients with rheumatic heart disease. Ann Thorac Surg , 2010, 89（5）：1437-1442.
  13. 13. 　Okada M, Usui A, Sakurai T, et al. Comparative study between cryoablation and radiofrequency ablation for surgical intervention of atrial fibrillation associated with mitral valve disease. Kyobu Geka, 2010, 63（4）：297-302.
  14. 14. 　Santarpino G, Rubino AS, Onorati F, et al. Atrial fibrillation ablation induces reverse remodelling and impacts cardiac function. Minerva Cardioangiol, 2011, 59（1）：17-29.
  15. 15. -592.
  16. 16. -841.