Department of Cardiology, Copenhagen University Hospital Herlev and Gentofte, Kildegaardsvej 28, 2900 Hellerup, Denmark.
Faculty of Health and Medical Sciences, University of Copenhagen, København, Denmark.
Eur Heart J. 2018 Feb 7;39(6):442-449. doi: 10.1093/eurheartj/ehx466.
During the last decade, ablation has increasingly been used in rhythm control management of patients with atrial fibrillation (AF). Over time, experience and techniques have improved and indications for ablation have expanded. The purpose of this study was to investigate whether the recurrence rate of AF following ablation has improved during last decade.
Through Danish nationwide registers, all patients with first-time AF ablation, between 2005 and 2014 in Denmark were identified. Recurrent AF after ablation was identified with 1 year follow-up. A total of 5425 patients undergoing first-time ablation were included. While patient median age increased over time the median AF duration prior to ablation decreased. The rates of recurrent AF decreased from 45% in 2005-2006 to 31% 2013-2014 with the relative risk of recurrent AF almost halved with an odds ratio of 0.57 [95% confidence intervals (95% CI) 0.47-0.68] in 2013-2014 compared with patients undergoing ablation in 2005-2006. Female gender, hypertension, AF duration >2 years, and cardioversion within 1 year prior to ablation were all associated with an increased risk of recurrent AF.
One year risk of recurrent AF following first-time ablation has almost halved from 2006 to 2014. Hypertension, female sex, cardioversion 1 year prior to ablation, and AF duration for more than 2 years all increased the associated risk of recurrent AF.
在过去的十年中,消融术在心房颤动(AF)患者的节律控制管理中越来越多地被应用。随着时间的推移,经验和技术得到了改善,消融术的适应证也得到了扩展。本研究旨在探讨在过去十年中,消融术后 AF 复发率是否有所改善。
通过丹麦全国登记处,确定了丹麦所有首次接受 AF 消融术的患者,时间范围为 2005 年至 2014 年。消融术后通过 1 年随访确定 AF 复发情况。共纳入 5425 例首次接受消融术的患者。尽管患者的中位年龄随时间推移而增加,但消融术前的中位 AF 持续时间却有所下降。AF 复发率从 2005-2006 年的 45%下降至 2013-2014 年的 31%,2013-2014 年的 AF 复发相对风险几乎减半,比值比(OR)为 0.57(95%置信区间(95%CI)0.47-0.68),与 2005-2006 年接受消融术的患者相比。女性、高血压、AF 持续时间>2 年、消融术 1 年前电复律均与 AF 复发风险增加相关。
首次消融术后 1 年 AF 复发风险从 2006 年到 2014 年几乎减半。高血压、女性、消融术 1 年前电复律、AF 持续时间超过 2 年均增加了 AF 复发的相关风险。