Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C.
J Cardiovasc Electrophysiol. 2010 Sep;21(9):966-72. doi: 10.1111/j.1540-8167.2010.01755.x.
Previous studies have indicated that atrial fibrillation (AF) in patients over the age of 60 at diagnosis is a risk factor for a substantial increase in cardiovascular events. However, information about the impact of age on the atrial substrate and clinical outcome after catheter ablation of AF is limited.
This study included 350 patients (53 ± 12 years, 254 males) who underwent circumferential pulmonary vein isolation (CPVI) of AF, guided by a NavX mapping system. The subjects were divided into three groups according to their age, as follows: Group I: age ≤50 (n = 141), Group II: age = 51-64 (n = 149) and Group III: age ≥65 years old (n = 60). The mean voltage and total activation time of the individual atria were obtained by using a NavX mapping system before ablation. Several parameters, including the gender, AF duration, and left atrial (LA) diameter were analyzed.
The younger age group had a significantly smaller LA diameter (Group I vs Group II vs Group III, 36.89 ± 7.11 vs 39.16 ± 5.65 vs 40.77 ± 4.95 mm, P = 0.002) and higher LA bipolar voltage (2.09 ± 0.83 vs 1.73 ± 0.73 vs 1.86 ± 0.67 mV, respectively, P = 0.024), compared with the older AF patients. The LA bipolar voltage exhibited a significant reduction when the patients became older, however, that did not occur in the right atrium. The incidence of an AF recurrence was higher in the older age group than in the younger age groups. A subgroup of patients with lone AF was analyzed and age was found to be an independent predictor of the AF recurrence after receiving the first CPVI in the multivariable model (P < 0.05).
Age has a significant impact on the LA substrate properties and outcome of the catheter ablation of AF.
先前的研究表明，诊断时年龄在 60 岁以上的患者的心房颤动（AF）是心血管事件大量增加的危险因素。然而，关于年龄对心房基质的影响以及 AF 导管消融后的临床结果的信息有限。
本研究纳入了 350 名（53±12 岁，254 名男性）接受环形肺静脉隔离（CPVI）的 AF 患者，该手术由 NavX 映射系统指导。根据年龄将患者分为三组：I 组：年龄≤50 岁（n=141），II 组：年龄=51-64 岁（n=149）和 III 组：年龄≥65 岁（n=60）。消融前使用 NavX 映射系统获得个体心房的平均电压和总激活时间。分析了包括性别、AF 持续时间和左心房（LA）直径在内的几个参数。
年龄较小的组 LA 直径明显较小（I 组比 II 组比 III 组，36.89±7.11 vs 39.16±5.65 vs 40.77±4.95 mm，P=0.002），LA 双极电压较高（2.09±0.83 vs 1.73±0.73 vs 1.86±0.67 mV，分别，P=0.024），与年龄较大的 AF 患者相比。随着患者年龄的增加，LA 双极电压显著降低，但右心房则没有。年龄较大的年龄组的 AF 复发率高于年龄较小的年龄组。对仅患有 AF 的患者进行亚组分析，发现年龄是多变量模型中接受首次 CPVI 后 AF 复发的独立预测因素（P<0.05）。
年龄对 LA 基质特性和 AF 导管消融的结果有显著影响。
