房内阻滞对新发或复发性心房颤动的预测价值：系统评价和荟萃分析。
Predictive value of inter-atrial block for new onset or recurrent atrial fibrillation: A systematic review and meta-analysis.
机构信息
Department of Medicine and Therapeutics, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, China; Li Ka Shing Institute of Health Sciences, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, China.
Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.
出版信息
Int J Cardiol. 2018 Jan 1;250:152-156. doi: 10.1016/j.ijcard.2017.09.176. Epub 2017 Oct 3.
BACKGROUND AND OBJECTIVES
Inter-atrial block (IAB) is characterized by a delay of inter-atrial conduction and is defined electrocardiographically by a P-wave duration (PWD)>120ms. Several studies have implicated IAB in the development of new onset atrial fibrillation (AF), whereas others have reported no significant associations. Moreover, there has been no systematic evaluation of the predictive value of IAB in AF recurrence. Therefore, we conducted a systematic review and meta-analysis to examine whether IAB predicts new onset AF or AF recurrence.
METHODS
PubMed and Embase databases were searched through 30th July 2017 for studies investigating the relationship between IAB and AF.
RESULTS
The initial search identified 260 studies, of which 16 studies met the inclusion criteria. This meta-analysis included 18,204 patients (mean age 56±13, 48% male) with a mean follow-up period of 15.1years. IAB significantly predicted new onset AF (hazard ratio [HR]: 2.42, 95% confidence interval [CI]: 1.44 to 4.07, P=0.001; 84%). For partial IAB, the risk of new onset AF did not reach statistical significance (HR: 1.42, 95% CI: 0.85 to 2.34; P=0.18; I=13%). Contrastingly, advanced IAB was a significant predictor of new onset AF with a pooled HR of 2.58 (95% CI: 1.35 to 4.96; P<0.01; I=67%). IAB also predicted AF recurrence after ablation (HR: 2.59, 95% CI: 1.35 to 4.96; P<0.01; I=67%).
CONCLUSIONS
IAB is a significant predictor of both new onset AF and AF recurrence.
背景与目的
房间隔阻滞（IAB）的特征为房间间传导延迟，心电图上表现为 P 波时限（PWD）>120ms。有几项研究提示 IAB 与新发心房颤动（AF）的发生有关，而另一些研究则未发现其有显著相关性。此外，也尚未对 IAB 在 AF 复发中的预测价值进行系统评估。因此，我们进行了一项系统回顾和荟萃分析，以检验 IAB 是否可预测新发 AF 或 AF 复发。
方法
通过检索 2017 年 7 月 30 日前的 PubMed 和 Embase 数据库，调查了 IAB 与 AF 之间关系的研究。
结果
最初的检索共确定了 260 项研究，其中 16 项符合纳入标准。本荟萃分析共纳入 18204 例患者（平均年龄 56±13 岁，48%为男性），平均随访时间为 15.1 年。IAB 显著预测新发 AF（风险比 [HR]：2.42，95%置信区间 [CI]：1.44 至 4.07，P=0.001；84%）。对于部分 IAB，新发 AF 的风险未达到统计学意义（HR：1.42，95% CI：0.85 至 2.34；P=0.18；I=13%）。相反，高级 IAB 是新发 AF 的显著预测因子，合并 HR 为 2.58（95% CI：1.35 至 4.96；P<0.01；I=67%）。IAB 也预测消融后的 AF 复发（HR：2.59，95% CI：1.35 至 4.96；P<0.01；I=67%）。
结论
IAB 是新发 AF 和 AF 复发的重要预测因子。
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