Nakatani Yosuke, Sakamoto Tamotsu, Yamaguchi Yoshiaki, Tsujino Yasushi, Kataoka Naoya, Nishida Kunihiro, Mizumaki Koichi, Kinugawa Koichiro
Second Department of Internal Medicine, University of Toyama, 2630 Sugitani, Toyama, 930-0194, Japan.
Nishida Medical Clinic, Toyama, Japan.
Heart Vessels. 2019 Aug;34(8):1351-1359. doi: 10.1007/s00380-019-01357-6. Epub 2019 Feb 8.
The increased body size correlates with the occurrence of atrial fibrillation (AF); however, the impact of the body size on the AF recurrence after ablation remains unclear. We enrolled 283 AF patients (179 paroxysmal, 51 persistent, and 53 long-standing persistent) who received ablation and assessed the correlation between the body surface area (BSA) and the AF recurrence. Furthermore, we measured the left atrial wall thickness using computed tomography. During the 12-month follow-up period, the AF freedom rates for patients with paroxysmal AF, persistent AF, and long-standing persistent AF were 83%, 76%, and 77%, respectively. The left atrial dimension, BSA, and body mass index (BMI) were higher in the AF-recurrent group compared with the AF-free group (left atrial dimension: 44.1 ± 7.5 mm vs. 41.7 ± 6.5 mm, P = 0.019; BSA: 1.81 ± 0.20 m vs. 1.72 ± 0.19 m, P = 0.002; BMI 25.0 ± 3.2 kg/m vs. 24.0 ± 3.2 kg/m, P = 0.035). The multivariate analysis revealed that only the BSA was an independent predictor of the AF recurrence after ablation (hazard ratio 6.843; 95% confidence interval 1.523-30.759, P = 0.012). The BSA significantly correlated with the left atrial wall thickness (R = 0.306, P < 0.001), and the left atrial wall thickness was higher in the AF-recurrent group compared with the AF-free group (2.00 ± 0.20 mm vs. 1.87 ± 0.17 mm, P < 0.001). The large body size correlates with the AF recurrence after ablation, which could be attributed to an increase in the left atrial wall thickness.
体型增加与房颤（AF）的发生相关；然而，体型对消融术后房颤复发的影响仍不明确。我们纳入了283例接受消融治疗的房颤患者（179例阵发性房颤、51例持续性房颤和53例长期持续性房颤），并评估体表面积（BSA）与房颤复发之间的相关性。此外，我们使用计算机断层扫描测量左心房壁厚度。在12个月的随访期内，阵发性房颤、持续性房颤和长期持续性房颤患者的无房颤率分别为83%、76%和77%。与无房颤组相比，房颤复发组的左心房内径、BSA和体重指数（BMI）更高（左心房内径：44.1±7.5mm对41.7±6.5mm，P = 0.019；BSA：1.81±0.20m对1.72±0.19m，P = 0.002；BMI 25.0±3.2kg/m对24.0±3.2kg/m，P = 0.035）。多因素分析显示，只有BSA是消融术后房颤复发的独立预测因素（风险比6.843；95%置信区间1.523 - 30.759，P = 0.012）。BSA与左心房壁厚度显著相关（R = 0.306，P < 0.001），与无房颤组相比，房颤复发组的左心房壁厚度更高（2.00±0.20mm对1.87±0.17mm，P < 0.001）。体型大与消融术后房颤复发相关，这可能归因于左心房壁厚度增加。
