An Kang, Zhu Jiaquan, Ma Nan, Tang Min, Mei Ju
Department of Cardiothoracic Surgery, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China.
Clin Cardiol. 2018 Mar;41(3):372-377. doi: 10.1002/clc.22878. Epub 2018 Feb 26.
Our previous study reported a modified endoscopic procedure for nonvalvular atrial fibrillation (AF) that requires only 3 ports in the left chest wall.
Certain preoperative variables might be predictive risk factors for AF recurrence among patients who underwent this procedure.
From October 2010 to April 2014, 114 patients with either paroxysmal AF (PAF) or nonparoxysmal AF (non-PAF) underwent the procedure and completed postoperative cardiac-rhythm measurement via electrocardiography and Holter monitoring. Univariate and multivariate analyses of the possible AF-related risk factors were conducted.
During 2-year follow-up, 99 of 114 patients (86.8%) were free from atrial tachyarrhythmia. Results from univariate analyses showed that AF duration, left atrial diameter (LAD), left atrial minimum volume, left atrial empty fraction, left atrial expansion index, and left atrial active empty fraction (LAAEF) were significantly associated with postoperative AF recurrence. Results from multivariate analyses showed that AF duration (odds ratio [OR]: 1.194, 95% CI: 1.063-1.340, P = 0.003), LAD (OR: 1.101, 95% CI: 1.005-1.205, P = 0.039), and LAAEF (OR: 0.490, 95% CI: 0.277-0.865, P = 0.014) were independent risk factors. There was no difference in AF recurrence between patients with PAF and non-PAF (P = 0.250).
Our 2-year follow-up study suggested that low LAAEF, long AF duration, and large LAD might be potential predictive risk factors for AF recurrence. Patients with PAF and non-PAF had a similar AF recurrence rate after modified endoscopic ablation.
我们之前的研究报告了一种改良的内镜手术治疗非瓣膜性心房颤动（房颤），该手术仅需在左胸壁开3个端口。
某些术前变量可能是接受该手术患者房颤复发的预测风险因素。
2010年10月至2014年4月，114例阵发性房颤（PAF）或非阵发性房颤（非PAF）患者接受了该手术，并通过心电图和动态心电图监测完成了术后心律测量。对可能的房颤相关风险因素进行单因素和多因素分析。
在2年的随访期间，114例患者中有99例（86.8%）无房性快速心律失常。单因素分析结果显示，房颤持续时间、左心房直径（LAD）、左心房最小容积、左心房排空分数、左心房扩张指数和左心房主动排空分数（LAAEF）与术后房颤复发显著相关。多因素分析结果显示，房颤持续时间（优势比[OR]：1.194，95%可信区间：1.063 - 1.340，P = 0.003）、LAD（OR：1.101，95%可信区间：1.005 - 1.205，P = 0.039）和LAAEF（OR：0.490，95%可信区间：0.277 - 0.865，P = 0.014）是独立风险因素。PAF和非PAF患者的房颤复发率无差异（P = 0.250）。
我们的2年随访研究表明，低LAAEF、长房颤持续时间和大LAD可能是房颤复发的潜在预测风险因素。改良内镜消融术后，PAF和非PAF患者的房颤复发率相似。
