Bunch T Jared, May Heidi T, Bair Tami L, Anderson Jeffrey L, Crandall Brian G, Cutler Michael J, Jacobs Victoria, Mallender Charles, Muhlestein Joseph B, Osborn Jeffrey S, Weiss J Peter, Day John D
From the Department of Cardiology, Intermountain Medical Center Heart Institute, Intermountain Medical Center, Murray, UT (T.J.B., H.T.M., T.L.B., J.L.A., B.G.C., M.J.C., V.J., C.M., J.B.M., J.S.O., J.P.W., J.D.D.); and Department of Internal Medicine, Stanford University, Palo Alto, CA (T.J.B.).
Circ Arrhythm Electrophysiol. 2015 Dec;8(6):1465-71. doi: 10.1161/CIRCEP.115.003013. Epub 2015 Oct 19.
There are a paucity of data about the long-term natural history of adult Wolff-Parkinson-White syndrome (WPW) patients in regard to risk of mortality and atrial fibrillation. We sought to describe the long-term outcomes of WPW patients and ascertain the impact of ablation on the natural history.
Three groups of patients were studied: 2 WPW populations (ablation: 872, no ablation: 1461) and a 1:5 control population (n=11 175). Long-term mortality and atrial fibrillation rates were determined. The average follow-up for the WPW group was 7.9±5.9 (median: 6.9) years and was similar between the ablation and nonablation groups. Death rates were similar between the WPW group versus the control group (hazard ratio, 0.96; 95% confidence interval, 0.83-1.11; P=0.56). Nonablated WPW patients had a higher long-term death risk compared with ablated WPW patients (hazard ratio, 2.10; 95% confidence interval: 1.50-20.93; P<0.0001). Incident atrial fibrillation risk was higher in the WPW group compared with the control population (hazard ratio, 1.55; 95% confidence interval, 1.29-1.87; P<0.0001). Nonablated WPW patients had lower risk than ablated patients (hazard ratio, 0.39; 95% confidence interval, 0.28-0.53; P<0.0001).
Long-term mortality rates in WPW patients are low and similar to an age-matched and gender-matched control population. WPW patients that underwent the multifactorial process of ablation had a lower mortality compared to nonablated WPW patients. Atrial fibrillation rates are high long-term, and ablation does not reduce this risk.
关于成人预激综合征（WPW）患者在死亡率和房颤风险方面的长期自然病史，相关数据较少。我们试图描述WPW患者的长期预后，并确定消融术对其自然病史的影响。
研究了三组患者：2个WPW人群（消融组：872例，未消融组：1461例）和一个1:5的对照组人群（n = 11175）。确定了长期死亡率和房颤发生率。WPW组的平均随访时间为7.9±5.9（中位数：6.9）年，消融组和未消融组相似。WPW组与对照组的死亡率相似（风险比，0.96；95%置信区间，0.83 - 1.11；P = 0.56）。与消融后的WPW患者相比，未消融的WPW患者有更高的长期死亡风险（风险比，2.10；95%置信区间：1.50 - 20.93；P < 0.0001）。WPW组的房颤发生风险高于对照组人群（风险比，1.55；95%置信区间，1.29 - 1.87；P < 0.0001）。未消融的WPW患者风险低于消融患者（风险比，0.39；95%置信区间，0.28 - 0.53；P < 0.0001）。
WPW患者的长期死亡率较低，与年龄和性别匹配的对照组人群相似。与未消融的WPW患者相比，接受多因素消融术的WPW患者死亡率较低。房颤发生率长期较高，消融术并不能降低这种风险。
