Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.
Tays Heart Hospital, Tampere University Hospital, Tampere, Finland.
J Interv Card Electrophysiol. 2022 Mar;63(2):357-367. doi: 10.1007/s10840-021-01011-0. Epub 2021 May 31.
Catheter ablation for atrial fibrillation (AF) is a standard procedure for maintaining sinus rhythm. The aim of this study was to evaluate treatment success and its predictors and to provide quality control data on complications and redo operations in a centre with an initially a low but currently high annual volume.
Data on patients (n = 1,253) treated with catheter ablation for AF in Tays Heart Hospital between January 2010 and May 2018 was evaluated (n = 1178 ablation-naïve patients and n = 1514 AF ablations). Comprehensive data on patient characteristics, treatment results, redo operations and complications were collected. Treatment success (maintenance of sinus rhythm at 1 year) was evaluated among patients residing within the hospital district (45% of the entire study population).
Treatment success was observed in approximately 62.9% of the ablation-naïve patients. Preoperative predictors of treatment success were paroxysmal AF type, previous use of antiarrhythmic drugs, left atrium diameter and age. The experience at the centre did not associate with the 1-year outcome. A relapse during the first 3-month blanking period was associated with a nine-fold risk of failure at 1 year (unadjusted OR 9.1, 95% CI 5.5-15.1, p < 0.001). The major complication rate was 4.5% (68/1514) with no deaths. Ten percent of the patients needed a redo procedure within the first year.
Patient-related factors are the most significant predictors of treatment success. A relapse during a 3-month blanking period is associated with a very high risk of failure at 1 year.
房颤（AF）的导管消融是维持窦性心律的标准程序。本研究旨在评估治疗成功率及其预测因素，并为一个初始年手术量较低但目前年手术量较高的中心的并发症和再次手术提供质量控制数据。
评估了 2010 年 1 月至 2018 年 5 月在泰斯心脏医院接受导管消融治疗 AF 的患者（消融初治患者 n=1178 例，AF 消融 n=1514 例）的数据。收集了患者特征、治疗结果、再次手术和并发症的综合数据。在医院所在地区（占整个研究人群的 45%）的患者中评估了治疗成功（1 年后维持窦性节律）。
消融初治患者中约 62.9%观察到治疗成功。治疗成功的术前预测因素为阵发性 AF 类型、先前使用抗心律失常药物、左心房直径和年龄。中心经验与 1 年结果无关。在 3 个月的空白期内复发与 1 年时失败的风险增加 9 倍相关（未经调整的 OR 9.1，95%CI 5.5-15.1，p<0.001）。主要并发症发生率为 4.5%（1514 例中有 68 例），无死亡病例。10%的患者在第一年需要再次手术。
患者相关因素是治疗成功的最重要预测因素。在 3 个月的空白期内复发与 1 年时失败的风险极高相关。
