University Heart Center Cologne, Dept. of Electrophysiology, Cologne, Germany.
Elisabeth Hosp. Berlin, Berlin, Germany.
Sci Rep. 2017 Nov 30;7(1):16678. doi: 10.1038/s41598-017-16938-6.
Catheter ablation (CA) for atrial fibrillation (AF) has emerged as a widespread first or second line treatment option. However, up to 45% of patients (pts) show recurrence of AF within 12 month after CA. We present prospective multicenter registry data comparing characteristics of pts with and without recurrence of AF within the first year after CA. This study comprises all pts with complete follow-up one year after CA (1-y-FU; n = 3679). During 1y-FU in 1687 (45.9%) pts recurrence of AF occurred. The multivariate analysis revealed female sex and AF type prior to the procedure as predictors for AF recurrence. Furthermore, comorbidities such as valvular heart disease and renal failure as well as an early AF relapse were also predictors of AF recurrence during 1-y-FU. However, despite an AF recurrence rate of 45.9%, the majority of these pts (72.4%) reported a significant alleviation of clinical symptoms. In conclusion in pts with initially successful CA for AF female sex, AF type, in-hospital AF relapse and comorbidities such as renal failure and valvular heart disease are independent predictors for AF recurrence during 1-y-FU. However, the majority of pts deemed their interventions as successful with significant reduction of symptoms irrespective of AF.
导管消融(CA)治疗心房颤动(AF)已成为广泛应用的一线或二线治疗选择。然而,多达 45%的患者(pts)在 CA 后 12 个月内出现 AF 复发。我们提出了一项前瞻性多中心登记研究数据,比较了 CA 后 1 年内 AF 复发和未复发患者的特征。这项研究包括了 CA 后 1 年随访完整的所有患者(1-y-FU;n=3679)。在 1-y-FU 期间,有 1687 例(45.9%)患者发生了 AF 复发。多变量分析显示,女性性别和术前 AF 类型是 AF 复发的预测因素。此外,合并症如瓣膜性心脏病和肾功能衰竭以及早期 AF 复发也是 1-y-FU 期间 AF 复发的预测因素。然而,尽管 AF 复发率为 45.9%,但这些患者中的大多数(72.4%)报告称临床症状有明显缓解。总之,对于最初成功 CA 治疗 AF 的患者,女性性别、AF 类型、住院期间 AF 复发以及合并症如肾功能衰竭和瓣膜性心脏病是 1-y-FU 期间 AF 复发的独立预测因素。然而,大多数患者认为他们的干预措施是成功的,尽管有 AF,但症状明显减轻。