影响二尖瓣球囊成形术后房颤转复的因素

探讨影响二尖瓣球囊成形术（ＰＢＭＶ）后心房纤颤（简称房颤）转复的因素。采用多元逐步回归分析法，对两组共３０例ＰＢＭＶ后房颤转复的患者进行回顾性分析。两组患者年龄、性别、房颤类型、心功能指数、瓣口面积和血液动力学改变差异不显著。但在失败组，左房内径、房颤持续时间和病程均明显大于成功组，同时发现房颤复发与其持续时间、左房内径大小及病程长短呈显著正相关。左房内径≥５０ｍｍ、房颤持续时间大于２年、病程≥２０年的ＰＢＭＶ后患者，房颤转复成功率低，应避免转复。

CARDIOVERSION OF ATRIAL FIBRILLATION AFTER PERCUTANEOUS BALLOON MITRAL VALVULOPLASTY FOR MITRAL STENOSIS

To investigate restoration of sinus rhythm in the patients after percutaneous balloon mitral valvulopasty(PBMV) for mitral stenosis with chronic atrial fibrillation.The clinical data before PBMV and the echocardiographic,hemodynamic data after and before PBMV were studied from 30 patients with pure mitral stenosis and atrial fibrillation.After PBMV,the patients had cardioversion of atrial fibrillation.The data of 17 patients who maintained sinus rhythm for more than 6 months (success group) were compared with the data of the 13 patients who failed to maintain sinus rhythm for more than 6 months(failure group).The patients in the success group had a shorter duration of atrial fibrillation and disease course,and had a smaller echocardiographic left atrial (LA) dimension before PBMV.Multiple regresson analysis showed the best predictors of successful cardioversion included echocardiographic LA dimension,duration of disease course and atrial fibrillation.The patients with atrial fibrillation for more than 2 years,disease course for more than 20 years and echocardiographic LA dimonsion for more than 50mm before PBMV had low rate of successful cardioversion.In the patients,cardioversion should be avoided after PBMV.