Department of Cardiology, Heart Rhythm Section, Ogaki Tokushukai Hospital, 6-85-1, Hayashimachi, Ogaki, 503-0015, Japan.
Department of Cardiology, National Hospital Organization Kyoto Medical Center, 1-1 Mukaihata-cho, Fukakusa, Fushimi-ku, Kyoto, 612-8555, Japan.
Heart Vessels. 2021 Aug;36(8):1219-1227. doi: 10.1007/s00380-021-01796-0. Epub 2021 Feb 11.
The impact of catheter ablation (CA) on the long-term clinical outcomes in atrial fibrillation (AF) are unclear due to limited cohort investigations.
The Fushimi AF Registry is a community-based prospective survey of patients with AF in Fushimi-ku, Kyoto, Japan. Of 4465 patients enrolled between March 2011 and July 2019, analyses were performed on 2639 patients (492 patients who underwent CA and 2147 patients who received standard rhythm- and/or rate-control drug therapy at baseline). We compared the baseline characteristics and the incidence of major adverse cardiovascular events (MACE: the composite of cardiovascular death, heart failure hospitalization, myocardial infarction, ischemic stroke or systemic embolism), and all-cause mortality during the follow-up using propensity score matching.
After entering 20 covariates in the current matching analysis, 342 patients who underwent CA and 342 matched patients who received drug therapy, with a median follow-up of 1865 days, were included. The patients who underwent CA were significantly associated with lower incidence of MACE (hazard ratio (HR) 0.56, 95% confidential interval (CI) 0.36-0.86; P = 0.0077), and all-cause mortality (HR 0.47, 95% CI 0.29-0.75; P = 0.0016).
CA was associated with lower incidences of MACE and all-cause mortality for patients with AF as compared with those who received drug therapy. The most common event of MACE in patients who underwent CA was heart failure hospitalization.
URL: http://www.umin.ac.jp/ctr/index.htm UNIQUE IDENTIFIER: UMIN000005834.
由于有限的队列研究，导管消融 (CA) 对心房颤动 (AF) 长期临床结局的影响尚不清楚。
伏见 AF 注册研究是一项针对日本京都府伏见区 AF 患者的基于社区的前瞻性调查。在 2011 年 3 月至 2019 年 7 月期间，共纳入 4465 例患者，其中 2639 例患者（492 例行 CA 治疗，2147 例患者在基线时接受标准节律和/或心率控制药物治疗）进行了分析。我们使用倾向评分匹配比较了基线特征和主要不良心血管事件（MACE：心血管死亡、心力衰竭住院、心肌梗死、缺血性卒中和全身性栓塞的复合终点）发生率以及随访期间的全因死亡率。
在当前匹配分析中纳入 20 个协变量后，共纳入 342 例接受 CA 治疗的患者和 342 例接受药物治疗的匹配患者，中位随访时间为 1865 天。与接受药物治疗的患者相比，接受 CA 治疗的患者 MACE（风险比（HR）0.56，95%置信区间（CI）0.36-0.86；P = 0.0077）和全因死亡率（HR 0.47，95% CI 0.29-0.75；P = 0.0016）的发生率显著降低。
与接受药物治疗的患者相比，CA 治疗可降低 AF 患者的 MACE 和全因死亡率。接受 CA 治疗的患者最常见的 MACE 事件是心力衰竭住院。
网址：http://www.umin.ac.jp/ctr/index.htm 唯一识别码：UMIN000005834。
