Xue Yangjing, Wang Xiaoning, Thapa Saroj, Wang Luping, Wang Jiaoni, Xu Zhiqiang, Wu Shaoze, Tao Luyuan, Wang Guoqiang, Qian Lu, Liao Lianming, Liu Baohua, Ji Kangting
Department of Cardiology, the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Xueyuanxi Road, No 109, Wenzhou, Zhejiang, 325000, China.
Department of Intensive Care Unit, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Tongbaibei Road, No 195, Zhengzhou, Henan, 450000, China.
BMC Cardiovasc Disord. 2017 May 8;17(1):109. doi: 10.1186/s12872-017-0533-2.
Long-term recurrence (LR) is a tendency that re-occurs within 3 months after catheter ablation for atrial fibrillation (AF). Whether very early recurrence (VER) within 7 days of post ablation is a prognostic factor of LR or not is unclear. For this reason, present study sought to examine the relationship between VER and LR.
In this prospective analysis 378 consecutive patients underwent an initial catheter ablation for paroxysmal or persistent AF. The association between VER and LR was analyzed by univariate and multivariate Cox regression, as well as time-dependent receiver operator characteristic (ROC) analysis.
After a mean follow-up of 14.71 ± 8.58 months, 81 (65.90%) patients with VER experienced LR and were associated with lower event of free survival from LR (Log rank test, P < 0.001). Multivariate Cox regression analysis revealed that VER (HR = 7.02, 95% CI = 4.78-10.31; P < 0.001), left atrial enlargement (HR = 2.92, 95% CI = 1.88-4.54; P < 0.001), tendency in advanced age (HR = 1.50, 95% CI = 0.99-2.28; P = 0.054), and tendency in male (HR = 0.71, 95% CI = 0.50-1.01; P = 0.060) were independent predictors of LR. According to time-dependent ROC analysis, it was found that VER was more sensitive than common risk factors in predicting LR (0.74 vs 0.66, P < 0.001) and combination model further improved the C statistic for predicting LR (0.82 vs 0.66, P < 0.001).
After a single procedure of catheter ablation, patients with VER were strongly associated with LR and combination of VER and common risk factors could further improve prediction of patients who were at high risk for LR.
长期复发（LR）是指房颤（AF）导管消融术后3个月内再次发作的一种倾向。消融术后7天内的极早期复发（VER）是否为LR的一个预后因素尚不清楚。因此，本研究旨在探讨VER与LR之间的关系。
在这项前瞻性分析中，378例连续患者接受了首次阵发性或持续性AF导管消融术。通过单因素和多因素Cox回归以及时间依赖性受试者工作特征（ROC）分析来分析VER与LR之间的关联。
平均随访14.71±8.58个月后，81例（65.90%）VER患者出现LR，且与LR的无事件生存率较低相关（对数秩检验，P<0.001）。多因素Cox回归分析显示，VER（HR=7.02，95%CI=4.78-10.31；P<0.001）、左心房扩大（HR=2.92，95%CI=1.88-4.54；P<0.001）、高龄倾向（HR=1.50，95%CI=0.99-2.28；P=0.054）和男性倾向（HR=0.71，95%CI=0.50-1.01；P=0.060）是LR的独立预测因素。根据时间依赖性ROC分析，发现VER在预测LR方面比常见危险因素更敏感（0.74对0.66，P<0.001），且联合模型进一步提高了预测LR的C统计量（0.82对0.66，P<0.001）。
单次导管消融术后，VER患者与LR密切相关，VER与常见危险因素的联合可进一步改善对LR高危患者的预测。
Zotero 插件
