Narui Ryohsuke, Yamane Teiichi, Tokuda Michifumi, Ikewaki Hirotsugu, Okajima Eri, Sato Hidenori, Oseto Hirotsuna, Isogai Ryota, Tokutake Kenichi, Yokoyama Kenichi, Kato Mika, Ito Keiichi, Tanigawa Shin-Ichi, Yamashita Seigo, Inada Keiichi, Matsuo Seiichiro, Miyanaga Satoru, Sugimoto Kenichi, Yoshimura Michihiro
Department of Cardiology, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan.
Heart Vessels. 2018 Jul;33(7):770-776. doi: 10.1007/s00380-017-1115-z. Epub 2018 Jan 22.
Atrial fibrillation (AF), especially asymptomatic cases, is often detected by medical checkups. We investigated the outcome of AF ablation in cases detected by medical checkups. We reviewed the data of 735 patients with AF (56 ± 10 years, paroxysmal: 441 patients) who underwent initial catheter ablation. All patients were divided into two groups based on their AF being diagnosed either by a medical checkup (group M) or not (group NM). AF was diagnosed by medical checkups in 263 (36%) patients. In Group M, the age was younger, time from the diagnosis to ablation shorter, left atrium dimension larger, and left ventricular ejection fraction lower than in Group NM. Male gender, persistent AF, and asymptomatic AF were more frequently seen in Group M than in Group NM. A mean of 13 ± 11 months after the initial ablation procedure, AF recurrence was more frequently observed in group M compared to group NM (P = 0.018). While the AF recurrence rate was similar in both groups in persistent AF patients (P = 0.87), it was more frequently observed in Group M than in Group NM in paroxysmal AF patients (P = 0.005). AF diagnosed by medical checkups was often associated with a worse outcome of catheter ablation, especially in paroxysmal AF patients.
心房颤动（AF），尤其是无症状病例，常通过体检被发现。我们调查了通过体检发现的AF病例行导管消融的结果。我们回顾了735例接受初次导管消融的AF患者（56±10岁，阵发性：441例）的数据。所有患者根据其AF是否通过体检诊断分为两组（体检组M和非体检组NM）。263例（36%）患者通过体检诊断为AF。与NM组相比，M组患者年龄更小，从诊断到消融的时间更短，左心房内径更大，左心室射血分数更低。M组男性、持续性AF和无症状AF的发生率高于NM组。初次消融术后平均13±11个月，M组AF复发率高于NM组（P = 0.018）。虽然持续性AF患者两组的AF复发率相似（P = 0.87），但阵发性AF患者中M组AF复发率高于NM组（P = 0.005）。通过体检诊断的AF常与导管消融效果较差相关，尤其是在阵发性AF患者中。
