Lee Wei-Chieh, Lee Yi-Wei, Fang Hsiu-Yu, Chen Huang-Chung, Chen Yung-Lung, Tsai Tzu-Hsien, Pan Kuo-Li, Lin Yu-Sheng, Chen Mien-Cheng
Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Pacing Clin Electrophysiol. 2019 Jul;42(7):882-889. doi: 10.1111/pace.13712. Epub 2019 May 21.
Catheter ablation has become an effective treatment modality for atrial fibrillation (AF). However, the relationship between common pulmonary vein (PV) and recurrent atrial tachyarrhythmia (ATA) after PV isolation (PVI) remains controversial. This study aimed to explore the function of common PV on the risk of recurrent ATA after PVI.
We identified a total of 191 patients who received radiofrequency catheter ablation for paroxysmal AF at our hospital between July 2010 and December 2017 for retrospective chart review. We collected the following data for analysis: results of preprocedural computed tomography, including the anatomy of PV and left atrial (LA) volume; the incidence of early- and late-onset recurrence of ATA. We compared these characteristics between the two groups defined by the presence or absence of the late-onset recurrence of ATA.
Compared to the no ATA recurrence group, the ATA recurrence group had larger LA size, larger LA end-diastolic and systolic volumes, larger maximal diameter of PV, higher prevalence of common PV, and higher incidence of early-onset recurrence of ATA. In multivariate logistic regression analyses, presence of common PV and early-onset recurrence were independently associated with late-onset recurrence of ATA. Compared to patients without common PV, patients with common PV had larger diameter of PV and higher incidence of late-onset recurrent ATA.
In patients with paroxysmal AF, early-onset recurrence of ATA and the presence of common PV were independently associated with late-onset recurrent ATA after radiofrequency catheter ablation.
导管消融已成为心房颤动（AF）的一种有效治疗方式。然而，肺静脉（PV）共干与PV隔离（PVI）后复发性房性快速心律失常（ATA）之间的关系仍存在争议。本研究旨在探讨PV共干对PVI后复发性ATA风险的影响。
我们确定了2010年7月至2017年12月期间在我院接受阵发性AF射频导管消融治疗的191例患者进行回顾性病历审查。我们收集了以下数据进行分析：术前计算机断层扫描结果，包括PV解剖结构和左心房（LA）容积；ATA早发和迟发复发的发生率。我们比较了由ATA迟发复发的有无定义的两组之间的这些特征。
与无ATA复发组相比，ATA复发组的LA尺寸更大、LA舒张末期和收缩末期容积更大、PV最大直径更大、PV共干的患病率更高以及ATA早发复发的发生率更高。在多因素逻辑回归分析中，PV共干的存在和早发复发与ATA迟发复发独立相关。与无PV共干的患者相比，有PV共干的患者PV直径更大且ATA迟发复发的发生率更高。
在阵发性AF患者中，ATA早发复发和PV共干的存在与射频导管消融术后ATA迟发复发独立相关。
