Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto City 860-8556, Japan.
Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto City 860-8556, Japan; International Research Center for Medical Sciences (IRCMS), Kumamoto University 2-2-1 Honjo, Chuo-ku, Kumamoto City 860-0811, Japan.
Int J Cardiol. 2020 Feb 1;300:147-153. doi: 10.1016/j.ijcard.2019.10.044. Epub 2019 Nov 18.
The impact of intra-atrial conduction delay on the recurrence of atrial tachyarrhythmia after radio frequency catheter ablation (RFCA) has not been fully elucidated.
We retrospectively analyzed 155 AF patients who were sinus rhythm at the start of RFCA. The conduction time from the onset of the earliest atrial electrogram at the high right atrium (HRA) to the end of the latest electrogram at the coronary sinus (CS) during sinus rhythm was defined as HRA-CS conduction time. Pulmonary vein isolation (PVI) was performed followed by linear roof lesion and complex fractionated atrial electrogram (CFAE) ablation until AF termination. We evaluated atrial tachyarrhythmia recurrence 12 months after RFCA.
The follow-up data were available for 148 patients. The recurrence of atrial tachyarrhythmia was noted in 28 (18.9%) patients. Atrial tachyarrhythmia recurrence patients had longer HRA-CS conduction times (151.3 ± 22.1 ms vs 160.1 ± 32.6 ms, p = .017). The patients were divided into the long or short HRA-CS conduction time group. The Kaplan-Meier analysis revealed that the long HRA-CS conduction time group held a higher risk of atrial tachyarrhythmia recurrence (log-rank test, p = .019). The multivariable Cox hazard analysis revealed that a long HRA-CS conduction time was a significant risk factor for the recurrence of atrial tachyarrhythmia, despite a long AF duration, persistent AF, and larger left atrial diameter (LAD) were not statistically significant.
The HRA-CS conduction time was the primary influencing factor that predicted the recurrence of atrial tachyarrhythmia after catheter ablation.
心房内传导延迟对射频导管消融（RFCA）后心房性快速心律失常（房速）复发的影响尚未完全阐明。
我们回顾性分析了 155 例窦性心律开始 RFCA 的 AF 患者。窦性心律时，从右心房（HRA）最早的心房电图起始到冠状窦（CS）最晚的电图结束的传导时间定义为 HRA-CS 传导时间。进行肺静脉隔离（PVI），然后进行线性房顶病变和复杂碎裂心房电图（CFAE）消融，直到 AF 终止。我们评估了 RFCA 后 12 个月的房速复发情况。
148 例患者可获得随访数据。28 例（18.9%）患者出现房速复发。房速复发患者的 HRA-CS 传导时间较长（151.3 ± 22.1 ms 比 160.1 ± 32.6 ms，p = 0.017）。患者被分为 HRA-CS 传导时间长或短组。Kaplan-Meier 分析显示，HRA-CS 传导时间较长组房速复发风险较高（对数秩检验，p = 0.019）。多变量 Cox 风险分析显示，尽管长 AF 持续时间、持续性 AF 和较大的左心房直径（LAD）不是统计学上显著的，但长 HRA-CS 传导时间是房速复发的显著危险因素。
HRA-CS 传导时间是预测导管消融后房速复发的主要影响因素。
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