Abstract: Objective To compare the effects of simultaneous bi-atrialbipolar radiofrequency ablation and simultaneous unipolar radiofrequency ablation during heart valve replacement in the treatment of patients with valvular heart disease complicated with atrial fibrillation, and the impact on echocardiographic parameters. Methods Using random number table method, 90 patients with valvular heart disease complicated with atrial fibrillation who were scheduled to undergo surgical treatment in the hospital from February 2022 to January 2025 were assigned to the bipolar group and the unipolar group, with 45 cases in each group.Both groups underwent heart valve replacement, and bi-atrial bipolar radiofrequency ablation and unipolar radiofrequency ablation were performed in the same period, respectively. The situation of sinus rhythm conversion at different time points after surgery was compared between the two groups. Echocardiographic parameters [left atrial diameter （LAD）, left ventricular ejection fraction （LVEF）, left ventricular fractional shortening （LVFS）and right atrial diameter （RAD）] of the two groups before surgery and at 3 months after surgery were compared. Postoperative complications observed in the two groups were recorded. Results The ablation time in the monopolar group was shorter than that in the bipolar group （P<0.05）; the sinus rhythm conversion rate in the bipolar group was higher than that in the monopolar group at 1 and 3 months post-operation （both P<0.05）; at 3 months post-operation, there was no statistically significant difference in left ventricular fractional shortening （LVFS） between the two groups （P>0.05）; the bipolar group had lower left atrial diameter （LAD） and right atrial diameter （RAD） than the monopolar group, and higher left ventricular ejection fraction （LVEF） than the monopolar group （all P<0.05）; the postoperative complication rate in the bipolar group was lower than that in the monopolar group （P<0.05）. Conclusion Concomitant biatrial bipolar radiofrequency ablation during cardiac valve replacement surgery can significantly improve cardiac function in patients with valvular heart disease combined with atrial fibrillation, reduce postoperative complications, and increase the postoperative sinus rhythm conversion rate.

Key words: valvular heart disease, heart valve replacement, bi-atrial bipolar radiofrequency ablation, atrial fibrillation, echocardiogram

摘要： 目的 对比心脏瓣膜置换术同期双房双极射频消融与同期单极射频消融的治疗效果及对超声心动图参数的影响。方法 以随机数表将本院2022年2月至2025年1月拟行外科手术治疗的90例心脏瓣膜病并发心房颤动患者分为双极组和单极组,各45例。两组均行心脏瓣膜置换术,同期分别行双房双极射频消融与单极射频消融术。比较两组术后不同时间点窦性心律转复情况;比较两组术前及术后3个月的超声心动图参数,包括左心房内径（LAD）、左室射血分数（LVEF）、左室缩短分数（LVFS）、右心房内径（RAD）;记录两组术后并发症发生情况。结果 单极组消融时间较双极组短（P<0.05）;双极组窦性心律转复率在术后1、3个月高于单极组（均P<0.05）;术后3个月,两组LVFS比较差异无统计学意义（P>0.05）;双极组LAD与RAD低于单极组,LVEF高于单极组（均P<0.05）;双极组术后并发症发生率较单极组低（P<0.05）。结论 心脏瓣膜置换术同期双房双极射频消融治疗,可显著改善心脏瓣膜病合并心房颤动患者的心功能,减少术后并发症,并提高术后窦性心律转复率。

关键词: 心脏瓣膜病, 心脏瓣膜置换术, 双房双极射频消融, 心房颤动, 超声心动图