SURGICAL TREATMENT OF ATRIAL FIBRILLATION-Evaluation of card iac and hemodynamic effects for atrial isolation procedure

心房颤动是临床上最常见的心律失常。房颤的发展会带来三种有害的后遗症：1)心律不齐；2)心脏血流动力学受损，主要是由于同步心房踢腿的丧失；3)血栓栓塞的易感性增加。慢性心房颤动患者将经历相关的血栓栓塞方法。1988年，Harada发明了右心房隔离术，其电生理作用是将右心房与心房颤动的起源分离，同时保持窦房结与心脏其余部分的正常功能和连续性。本研究的目的是评估心功能和血流动力学的影响，并将该手术安全地应用于心房颤动患者。术后平均心房压、脑卒中容积指数、左房压、右房压、Emax等指标的心脏及血流动力学性能与术前无明显变化，均保持在正常范围内。根据这些结果，该手术适用于两例房颤和房间隔缺损患者。术后窦性心律维持正常10个月，房颤消失。我们得出结论，本研究的目的是达到这些结果。

Atrial fibrillation is the most common arrhythmia noted in clinical practice. Three detrimental sequelae result from the development of atrial fibrillation: 1)an irregular heartbeat, 2)impaired cardiac hemodynamics, primarily because of loss of the synchronous atrial kick, and 3)an increased vulnerability to thromboembolism. Patients with chronic atrial fibrillation will experience an associated thromboembolic epithod. In 1988, Harada developped right atria isolation procedure, that has electrophysiologic effects of isolating the right atrium with the origin of atrial fibrillation while preserving normal function and continuity of the sinoatrial node with the remainder of the heart.Purpose of this study is to evaluate the cardiac function and hemodynamic effects, and apply this procedure to the patients with atrial fibrillation safely. Postopeartive cardiac and hemodynamic performance from some parameter of mean atria pressure, stroke volume index, left atrial pressure, right atrial pressure and Emax does not show significant changes for preoperative performance, and remained within normal limit. From these results, this procedure was applied two patients with atrial fibrillation and atrial septal defect. Postoperative normal sinus rhythm maintained for 10 months with disappearing atrial fibrillation. We conclude that the purpose of this study was achieved from these results.