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功能性二尖瓣反流与导管消融后阵发性心房颤动复发的关系:一项前瞻性队列研究。

Association between functional mitral regurgitation and recurrence of paroxysmal atrial fibrillation following catheter ablation: a prospective cohort study.

机构信息

Department of Cardiology, The Second Affiliated Hospital of Xiamen Medical College, Xiamen, China.

Department of Neurology, Jinjiang Municipal Hospital, Jinjiang, China.

出版信息

J Int Med Res. 2021 May;49(5):3000605211014375. doi: 10.1177/03000605211014375.

Abstract

OBJECTIVE

The present study aimed to investigate the effect of functional mitral regurgitation (FMR) on recurrence of paroxysmal atrial fibrillation (PAF) in patients undergoing radiofrequency catheter ablation.

METHODS

This prospective cohort study comprised 107 patients with PAF. The patients were divided into the FMR and non-FMR groups. FMR was assessed by Doppler echocardiography before index ablation. All patients initially underwent circumferential pulmonary vein isolation (CPVI) and were followed up for 12 months after ablation. PAF, atrial tachycardia, or atrial flutter served as the endpoint indicator.

RESULTS

The median duration of PAF was 24 (3-60) months. Binary logistic univariate and multivariate analyses showed that FMR was not a risk factor for recurrence of catheter ablation for PAF (hazard ratio=0.758, 95% confidence interval: 0.191-3.004; hazard ratio=0.665, 95% confidence interval: 0.134-3.300, respectively). Kaplan-Meier analysis showed no significant difference in the recurrence rate between the groups. Fifteen (15/107, 14%) cases of PAF were triggered by the pulmonary vein. Three (3/107, 2.8%) cases of PAF were triggered by the superior vena cava.

CONCLUSIONS

FMR is not an independent risk factor for predicting recurrence of catheter ablation for PAF. FMR does not affect patients undergoing radiofrequency catheter ablation for PAF.

摘要

目的

本研究旨在探讨功能性二尖瓣反流(FMR)对接受射频导管消融术的阵发性心房颤动(PAF)患者复发的影响。

方法

这项前瞻性队列研究纳入了 107 例 PAF 患者。患者分为 FMR 组和非 FMR 组。在指数消融前,通过多普勒超声心动图评估 FMR。所有患者最初均行环形肺静脉隔离(CPVI),消融后随访 12 个月。PAF、房性心动过速或房扑作为终点指标。

结果

PAF 的中位持续时间为 24 个月(3-60 个月)。二元逻辑单变量和多变量分析显示,FMR 不是导管消融治疗 PAF 复发的危险因素(风险比=0.758,95%置信区间:0.191-3.004;风险比=0.665,95%置信区间:0.134-3.300)。Kaplan-Meier 分析显示两组间的复发率无显著差异。15 例(15/107,14%)PAF 由肺静脉触发。3 例(3/107,2.8%)PAF 由上腔静脉触发。

结论

FMR 不是预测 PAF 导管消融复发的独立危险因素。FMR 不会影响接受射频导管消融治疗 PAF 的患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/60ba/8127776/297d8c31d0a5/10.1177_03000605211014375-fig1.jpg

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