Cardiac Arrhythmia Service, Institute for Heart, Stroke and Vascular Care, Massachusetts General Hospital, Boston, MA, USA Division of Cardiovascular Medicine, University at Buffalo School of Medicine and Biomedical Sciences, NY, USA.
Cardiac Arrhythmia Service, Institute for Heart, Stroke and Vascular Care, Massachusetts General Hospital, Boston, MA, USA.
Europace. 2014 Oct;16(10):1508-14. doi: 10.1093/europace/euu129. Epub 2014 Jun 6.
To determine the incidence and predictors of atrial fibrillation (AF) and its impact on survival in patients with other forms of supraventricular arrhythmias (SVAs) including atrial flutter (AFL), atrial tachycardia (AT), atrioventricular reentrant (AVRT), and AV nodal reentrant tachycardia (AVNRT). We hypothesized that SVA may increase risk of AF and concomitant AF may influence long-term survival.
All patients who underwent catheter ablation for SVA from 2000 to 2010 were included in this study. The patients were identified retrospectively and the vital status determined prospectively. Observed survival in the study cohort was compared with survival rates in the age- and sex-matched general population. The study group included 1573 patients (mean age 50.5 ± 18 years, 47% female) with AVNRT (38.5%), AFL (29.6%), AVRT (22.6%) and AT (9.3%). The patients were followed for a mean of 35 months (median 23 months). Atrial fibrillation was documented in 424 patients (27%) with a higher incidence in males (35 vs. 18%). Atrial fibrillation was present in 19.6% of patients before the ablation and developed in 9.07% after ablation. Atrial fibrillation commonly occurred in patients with AFL (57.5%), AT (27.4%), AVRT (13.5%), and AVNRT (9.7%). Older age, prolonged PR interval, dilated left atrium, low left ventricular ejection fraction and presence of AFL were independent predictors for concomitant AF. Long-term survival was worse in the presence of AF.
The incidence of AF is high in patients with other forms of SVA. The most common association is between AFL and AF. Long-term survival is decreased in those who have concomitant AF, although AF did not emerge as an independent predictor of mortality when adjusted for other covariates.
确定其他类型的室上性心律失常（SVAs）包括心房扑动（AFL）、心房颤动（AT）、房室折返性心动过速（AVRT）和房室结折返性心动过速（AVNRT）患者中房颤（AF）的发生率和预测因素及其对生存的影响。我们假设 SVA 可能会增加 AF 的风险，而同时存在的 AF 可能会影响长期生存。
本研究纳入了 2000 年至 2010 年间因 SVA 行导管消融的所有患者。这些患者通过回顾性识别，并前瞻性确定其生存状态。研究队列中的观察生存与年龄和性别匹配的一般人群的生存率进行比较。研究组包括 1573 名患者（平均年龄 50.5 ± 18 岁，47%为女性），其中 AVNRT（38.5%）、AFL（29.6%）、AVRT（22.6%）和 AT（9.3%）。患者平均随访 35 个月（中位数 23 个月）。424 名患者（27%）被诊断为房颤，男性的发生率更高（35%比 18%）。在消融前有 19.6%的患者存在房颤，消融后有 9.07%的患者出现房颤。房颤常见于 AFL（57.5%）、AT（27.4%）、AVRT（13.5%）和 AVNRT（9.7%）患者中。年龄较大、PR 间期延长、左心房扩大、左心室射血分数较低和 AFL 存在是同时发生 AF 的独立预测因素。存在 AF 时长期生存率较差。
其他类型的 SVA 患者中房颤的发生率较高。最常见的关联是 AFL 和 AF。尽管在调整其他协变量后，AF 并未成为死亡率的独立预测因素，但同时存在 AF 的患者长期生存率降低。
