肺静脉口弧形指数与房颤消融术后复发的关系

目的:探讨肺静脉口弧形指数与心房颤动(房颤)导管消融术后复发的关系。方法:选取2008年2月至2011年3月在我院接受导管消融术的房颤患者120例,所有患者于术前3日内利用多排CT行左心房及肺静脉造影,并进行图像的三维重建。测量每条肺静脉前后径及上下径,并计算弧形指数(肺静脉前后径/肺静脉上下径)以描述肺静脉口形态。行射频消融治疗的房颤病人全部达消融终点,术后随访超过3个月,根据患者房性快速性心律失常(房颤、房扑或房速)的发生情况,将其分为治愈组和复发组,进行统计分析。结果:由弧形指数分析,四支肺静脉开口形态存在统计学差异(P0.05);房颤消融术后,53例病人复发。房颤消融术后复发患者的LIPV弧形指数与治愈者不同,差异有显著性(P0.05);两组患者的左上肺静脉(Left Superior Pulmonary Vein,LSPV),右上肺静脉(Right Superior Pulmonary Vein,RSPV),右肺下静脉(Right Inferior Pulmonary Vein,RIPV),的弧形指数比较差异不明显(P0.05)。结论:左下肺静脉形态的不一致性与房颤导管消融术复发有关。

Relationship of the Venous OstiumIndex(VOI) of Pulmonary Vein andRecurrences of Atrial Fibrillation after Catheter Ablation

Objective:To investigate the relationship between the venous ostium index (VOI) of the pulmonary vein andrecurrences of atrial fibrillation after catheter ablation.Methods:120 patients with atrial fibrillation (AF) who were undergoing catheterablation in our hospital from February 2008 to March 2011 were selected. Multi-slice Spiral computer tomography (MSCT) wasperformed in all patients. Pulmonary vein (PV) anatomy was evaluated, and diameters of PVs ostia were measured. To determine theshape of ostia, the venous ostium imdex (VOI) was calculated for all veins by dividing anterior-posterior measurements bysuperior-inferior measurements. After the procedure, patients underwent follow-up every month.Results:The venous ostium imdex(VOI)was calculated which showed that the ostia of RSPV and RIPV were more round than those of LSPV and LIPV (P<0.05). There wasstatistically significant difference between two groups about the VOI of LIPV (P<0.05). There was no statistically significant differenceabout the indexes of LSPV, RSPV and RIPV between two groups (P>0.05).Conclusion:It is suggested that there is a relation betweenvenous ostiumindex(VOI) of the pulmonary vein and recurrences of atrial fibrillation after catheter ablation.