| 苏欣欣,胡一东,陈兴叶,等.导管消融联合左心耳封堵术治疗心房颤动伴心力衰竭患者的效果[J].中国临床保健杂志,2026,29(2):205-210. |
| 导管消融联合左心耳封堵术治疗心房颤动伴心力衰竭患者的效果 |
| The efficacy of catheter ablation combined with left atrial appendage occlusion in patients with atrial fibrillation and heart failure |
| 投稿时间：2025-12-10 |
| DOI：10.3969/J.issn.1672-6790.2026.02.012 |
| 中文关键词: 心房颤动 心力衰竭 导管消融术 左心耳封堵术 |
| 英文关键词: Atrial fibrillation Heart failure Catheter ablation Left atrial appendage closure Fund programs:Anhui Provincial Special Project for Clinical Medical Research and Transformation |
| 基金项目:安徽省临床医学研究转化专项项目 |
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| 中文摘要: |
| 目的 探讨导管消融联合左心耳封堵术治疗心房颤动伴心力衰竭患者的效果与安全性。方法 回顾性分析2020年9月至2022年2月在中国科学技术大学附属第一医院(安徽省立医院)心内科接受导管消融联合左心耳封堵术的非瓣膜性心房颤动(NVAF)的患者病历资料,根据左心室射血分数(LVEF)将患者分为心力衰竭组(HF组,LVEF<50%)和非心力衰竭组(NHF组,LVEF≥50%且无心力衰竭诊断)。分析心律失常复发率、术后并发症、左心室功能及心脏相关再入院率。结果 与NHF组比较,HF组(30例)的体重指数较低(P=0.009),氨基末端脑钠肽前体水平较高(P=0.001),左心室舒张末期内径较大(P＜0.001),差异均有统计学意义。围手术期并发症HF组发生3例,NHF组发生4例,两组围手术期并发症发生率比较,差异无统计学意义(P＝0.186)。此外,两组在术后心律失常复发率、残余分流、脑卒中事件、出血事件及心脏相关再入院率方面比较,差异均无统计学意义(均P＞0.05)。然而,HF组术后LVEF较术前显著改善。结论 导管消融联合左心耳封堵术是治疗心房颤动的有效方式,对伴有心力衰竭的NVAF患者可能具有与单独导管消融或单独左心耳封堵术相似的治疗效果与安全性,同时能够改善心功能。 |
| 英文摘要: |
| Objective To evaluate the clinical outcomes of catheter ablation combined with left atrial appendage closure in patients with non-valvular atrial fibrillation (NVAF) and concomitant heart failure.Methods A retrospective analysis was conducted on NVAF patients who underwent combined catheter ablation and left atrial appendage closure in the Department of Cardiology at the First Affiliated Hospital of the University of Science and Technology of China from September 2020 to February 2022.Patients were stratified into heart failure [HF,left ventricular ejection fraction (LVEF)<50%] and non-heart failure (NHF,LVEF≥50% and no clinical diagnosis of heart failure) groups according to baseline LVEF.Clinical characteristics,arrhythmia recurrence,perioperative complications,left ventricular function,residual left atrial appendage flow,thromboembolic and bleeding events,and cardiac-related hospitalizations were assessed during follow-up.Results Compared with the NHF group,the HF group exhibited significantly lower body mass index (BMI) (P=0.009),higher levels of N-terminal pro-brain natriuretic peptide (P=0.001),and greater left ventricular end-diastolic diameter (P＜0.001).The incidence of perioperative complications was 3 patients in the HF group and 4 patients in the NHF group,with no statistically significant difference between groups (P=0.186).No significant differences were observed between the two groups in terms of arrhythmia recurrence,residual shunt,stroke,major bleeding,or cardiac-related rehospitalization rates.Notably,LVEF in the HF group showed a significant improvement from baseline to post-procedure (P<0.05).Conclusions The combined catheter ablation and left atrial appendage closure is an effective treatment for atrial fibrillation,and it may offer similar therapeutic efficacy and safety for NVAF patients with heart failure as catheter ablation or left atrial appendage closure alone,while also improving cardiac function. |
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