肺动脉高压与导管消融术后阵发性心房颤动晚期复发的相关性。
The correlation of pulmonary arterial hypertension with late recurrence of paroxysmal atrial fibrillation after catheter ablation.
作者信息
Zhang Yan-Qun, Zhang Fei-Long, Wang Wei-Wei, Chen Xue-Hai, Chen Jian-Hua, Chen Liang-Long
机构信息
Deparment of Medical Ultrasonics, Xiamen Branch, Zhongshan Hospital, Fudan University, Xiamen 361000, China.
Department of Cardiology, Fujian Medical University Union Hospital, Fuzhou 350001, China.
出版信息
J Thorac Dis. 2018 May;10(5):2789-2794. doi: 10.21037/jtd.2018.04.92.
BACKGROUND
Paroxysmal atrial fibrillation (PAF) is one of the most common clinical arrhythmias. Although radiofrequency catheter ablation (RFCA) for the treatment of atrial fibrillation has continuously matured and developed in recent years, some patients treated with RFCA continued to have atrial fibrillation recurrence, and the recurrence rate was high. Determining indicators to predict the recurrence of PAF after RFCA is significantly important for improving the surgical success rate and guiding clinical work. This study aimed to investigate the influence of pulmonary arterial hypertension (PAH) on the late recurrence of PAF after RFCA.
METHODS
A total of 300 patients with PAF, who underwent RFCA for the first time at the Department of Cardiology of Fujian Union Medical College Hospital from January 2013 to October 2016, were retrospectively studied. These patients were regularly followed-up from 3 months at least to 3 years and clinical data were collected. In order to observe the 100 PAF patients with PAH were assigned into the observation group, and 200 PAF patients without PAH were assigned as the control group. PAH and its related clinical characteristics were evaluated by univariate analysis of variance (ANOVA) and logistic regression analysis.
RESULTS
The follow-up results revealed that 34 patients had early recurrence, and the early arrhythmia recurrence rate was 11.3%. Furthermore, 22 patients had late recurrence, including 19 patients with atrial fibrillation and three patients with atrial flutter; and the late recurrence rate was 7.3%. The univariate ANOVA revealed that PAH (P=0.001), early recurrence (P=0.014) and Left atrial diameter (LAD) (P=0.023) had significant effects on late recurrence after PAF ablation. Furthermore, logistic regression analysis revealed that PAH (P=0.049, OR =1.053, 95% CI: 1.000-1.109) was independently correlated to late recurrence of PAF.
CONCLUSIONS
PAH is a predictive factor for late recurrence of PAF after RFCA.
背景
阵发性心房颤动（PAF）是最常见的临床心律失常之一。尽管近年来用于治疗心房颤动的射频导管消融术（RFCA）不断成熟和发展，但一些接受RFCA治疗的患者仍持续出现心房颤动复发，且复发率较高。确定预测RFCA术后PAF复发的指标对于提高手术成功率和指导临床工作具有重要意义。本研究旨在探讨肺动脉高压（PAH）对RFCA术后PAF晚期复发的影响。
方法
回顾性研究2013年1月至2016年10月在福建医科大学附属协和医院心内科首次接受RFCA治疗的300例PAF患者。这些患者至少随访3个月至3年，并收集临床资料。为观察PAH情况，将100例PAF患者分为观察组，200例无PAH的PAF患者作为对照组。通过单因素方差分析（ANOVA）和逻辑回归分析评估PAH及其相关临床特征。
结果
随访结果显示，34例患者出现早期复发，早期心律失常复发率为11.3%。此外，22例患者出现晚期复发，其中包括19例心房颤动患者和3例心房扑动患者；晚期复发率为7.3%。单因素方差分析显示，PAH（P = 0.001）、早期复发（P = 0.014）和左心房直径（LAD）（P = 0.023）对PAF消融术后晚期复发有显著影响。此外，逻辑回归分析显示，PAH（P = 0.049，OR = 1.053，95%CI：1.000 - 1.109）与PAF晚期复发独立相关。
结论
PAH是RFCA术后PAF晚期复发的预测因素。
Zotero 插件