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目的探讨上腔静脉电隔离(SVCI)在环肺静脉电隔离(CPVI)治疗阵发性心房颤动(PAF)的作用。方法回顾分析导管射频消融(RFCA)的PAF患者103例,依据电生理检查及RFCA的结果分为:单纯CPVI组和CPVI+SVCI组,随访1年以上,观察AF复发率及并发症情况。结果入选103例患者共消融120人次,其中11例消融2次,3例消融3次。综合电生理检查及RFCA结果进行分组:单纯CPVI组88例、CPVI+SVCI组15例。随访期间,共计81例成功,累积成功率78.6%;CPVI+SVCI组13例成功,累积成功率86.7%;单纯CPVI组68例成功,累积成功率77.3%。CPVI+SVCI组术后有1例患者出现膈神经损伤,术后3个月未恢复。结论 SVC是常见的AF触发灶之一,SVCI有助提高行CPVI的PAF患者的消融成功率。
Objective To investigate the role of superior vena cava electrical isolation (SVCI) in the treatment of paroxysmal atrial fibrillation (PAF) by circumferential pulmonary vein isolation (CPVI). Methods A total of 103 patients with PAF undergoing catheter radiofrequency catheter ablation (RFCA) were retrospectively analyzed. According to the result of electrophysiological examination and RFCA, the patients were divided into simple CPVI group and CPVI + SVCI group, followed up for more than 1 year. The incidences of AF recurrence and complications were observed. Results A total of 120 patients were included in the study. Among them, 11 were ablated twice and three ablated three times. The results of comprehensive electrophysiological examination and RFCA were grouped as follows: 88 cases in simple CPVI group and 15 cases in CPVI + SVCI group. During the follow-up period, a total of 81 cases were successful with a cumulative success rate of 78.6%. In the CPVI + SVCI group, 13 cases were successful with a cumulative success rate of 86.7%. 68 cases were successful in CPVI group with a cumulative success rate of 77.3%. One patient in the CPVI + SVCI group had phrenic nerve injury and did not recover after 3 months. Conclusions SVC is one of the common AF triggers. SVCI can improve the success rate of ablation in PAF patients undergoing CPVI.