Heidbüchel Hein, Anné Wim, Willems Rik, Adriaenssens Bert, Van de Werf Frans, Ector Hugo
Department of Cardiology, University Hospital Gasthuisberg, University of Leuven, Herestraat 49, B-3000 Leuven, Belgium.
Int J Cardiol. 2006 Feb 8;107(1):67-72. doi: 10.1016/j.ijcard.2005.02.043.
Sports activity has been associated with the development of atrial arrhythmias. Atrial fibrillation (AF) is frequently observed after successful ablation for atrial flutter. Sports activity as a risk factor for AF development after flutter ablation has not been studied.
We analyzed outcome in 137 patients (83% men) after ablation for isthmus-dependent atrial flutter (excluding patients with concomitant ablation for atrial tachycardia or fibrillation). Sports activity before and after ablation was evaluated by detailed questionnaires. Endurance sports was defined as (semi-)competitive participation in cycling, running or swimming for > or =3 h/week (and for > or =3 years pre-ablation). Median follow-up was 2.5 years. Survival free of AF was evaluated with Kaplan-Meier curves and log-rank statistics. Multivariate analysis was based on Cox proportional hazard evaluation.
Acute ablation success was 99% and flutter recurrence 4.4%. Thirty-one patients (23%) had been regularly engaged in endurance sports before ablation and 19 (14%) continued regular sports activity afterwards. Those performing sports were slightly younger. A history of endurance sports was a significant risk factor for post-ablation AF (univariate HR 1.96 (1.19-3.22), p<0.01, and multivariate HR 1.81 (1.10-2.98), p=0.02). Also continuation of endurance sports activity after ablation showed a trend for increased risk to develop AF despite a relatively small sample size (n=19; multivariate HR 1.68 (0.92-3.06), p=0.08). Cox proportional hazard calculations revealed a 10% and 11% increased risk for AF development per weekly hour sport performed before and after ablation respectively (p<0.01 for both).
A history of endurance sports activity is associated with the development of AF after ablation of atrial flutter.
体育活动与房性心律失常的发生有关。心房颤动（AF）在成功消融心房扑动后经常出现。体育活动作为心房扑动消融后房颤发生的危险因素尚未得到研究。
我们分析了137例（83%为男性）峡部依赖性心房扑动消融术后的结果（排除同时进行房性心动过速或房颤消融的患者）。通过详细问卷评估消融前后的体育活动情况。耐力运动定义为（半）竞争性地参与骑自行车、跑步或游泳，每周≥3小时（且消融前≥3年）。中位随访时间为2.5年。采用Kaplan-Meier曲线和对数秩统计评估无房颤生存期。多变量分析基于Cox比例风险评估。
急性消融成功率为99%，扑动复发率为4.4%。31例（23%）患者在消融前经常进行耐力运动，19例（14%）在消融后继续进行常规体育活动。进行体育活动的患者年龄稍小。耐力运动史是消融后房颤的一个重要危险因素（单变量HR 1.96（1.19 - 3.22），p<0.01，多变量HR 1.81（1.10 - 2.98），p = 0.02）。尽管样本量相对较小（n = 19），但消融后继续进行耐力运动也显示出房颤发生风险增加的趋势（多变量HR 1.68（0.92 - 3.06），p = 0.08）。Cox比例风险计算显示，消融前和消融后每周每进行一小时体育活动，房颤发生风险分别增加10%和11%（两者p均<0.01）。
耐力运动史与心房扑动消融后房颤的发生有关。
