Johansson Birgitta, Houltz Birgitta, Berglin Eva, Brandrup-Wognsen Gunnar, Karlsson Thomas, Edvardsson Nils
Department of Cardiology, Sahlgrenska University Hospital, S-413 45 Göteborg, Sweden.
Europace. 2008 May;10(5):610-7. doi: 10.1093/europace/eun066. Epub 2008 Mar 28.
Our aim was to compare the long-term effects on rhythm and quality of life (QoL) after left atrial epicardial radiofrequency (RF) ablation vs. no ablation in patients undergoing cardiac surgery.
Thirty-nine patients with ECG documented atrial fibrillation (AF) scheduled for coronary artery bypass grafting (CABG) with or without concomitant valve surgery were consecutively elected for epicardial RF ablation. Thirty-nine age- and gender-matched patients scheduled for CABG with or without concomitant valve surgery only and with documented AF served as controls. The follow-up after ablation was 32 +/- 11 months. The percentage of patients in sinus rhythm (SR) at long-term follow-up was 62 vs. 33% (P = 0.03) after ablation and no ablation, respectively. SR at 3 months was highly predictive of that at 32 months (sensitivity 95%, positive predictive value 86%). Long-term SR was associated with better QoL, fewer symptoms, higher ejection fraction, and smaller left and right atria than AF.
SR at 3 months was highly predictive of long-term SR that was associated with clinical improvement when compared with patients still in AF. AF at 3 months did not preclude a later stabilization to SR.
我们的目的是比较心脏手术患者中，左心房心外膜射频（RF）消融与不进行消融对心律和生活质量（QoL）的长期影响。
连续入选39例计划行冠状动脉旁路移植术（CABG）且伴有或不伴有瓣膜手术的心电图记录为心房颤动（AF）的患者，进行心外膜RF消融。39例年龄和性别匹配、计划行CABG且伴有或不伴有瓣膜手术、有AF记录的患者作为对照。消融后的随访时间为32±11个月。长期随访时，消融组和未消融组窦性心律（SR）患者的百分比分别为62%和33%（P = 0.03）。3个月时的SR对32个月时的SR具有高度预测性（敏感性95%，阳性预测值86%）。与AF相比，长期SR与更好的QoL、更少的症状、更高的射血分数以及更小的左、右心房相关。
与仍处于AF的患者相比，3个月时的SR对长期SR具有高度预测性，且长期SR与临床改善相关。3个月时的AF并不排除后期稳定为SR。
