Chen Xiaowei, Zhao Jiangtao, Zhu Kui, Qin Fen, Liu Hengdao, Tao Hailong
Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Front Cardiovasc Med. 2021 Nov 19;8:756552. doi: 10.3389/fcvm.2021.756552. eCollection 2021.
The connection between revascularization for coronary artery disease (CAD) and the incidence of recurrent events of atrial fibrillation (AF) after ablation is unclear. This study aimed to explore the relationship between coronary revascularization and AF recurrence in patients who underwent radiofrequency catheter ablation (RFCA). Four hundred and nineteen patients who underwent performed coronary angiography at the same time as RFCA were enrolled in this study. Obstructive CAD was defined as at least one coronary artery vessel stenosis of ≥75% and percutaneous coronary intervention (PCI) was recommended. Non-obstructive CAD was defined as coronary artery vessel stenosis of <75%. The endpoint was freedom from recurrence from AF after RFCA during the 24-month follow-up. In total, 102, 95, and 212 patients were undergone coronary angiography and diagnosed as having obstructive CAD, Non-obstructive CAD, and Non-CAD, respectively. During the 24-month follow-up period, patients without obstructive CAD were significantly more likely to achieve freedom from AF than patients with obstructive CAD (hazard ratio [HR]: 1.72; 95% confidence interval [CI]: 1.23-2.41; = 0.001). The recurrence rate of AF was significantly lower in patients who underwent PCI than in those who did not (HR: 0.45; 95% CI: 0.25-0.80; = 0.007). The multivariate regression analysis showed that the other predictors of AF recurrence for obstructive CAD were multivessel stenosis (HR: 1.92; 95% CI: 1.04-3.54; = 0.036) and left atrial diameter (HR: 2.56; 95% CI: 1.31-5.00; = 0.006). This study suggests that obstructive CAD is associated with a higher rate of AF recurrence. Additionally, For patients with CAD, coronary revascularization is related to a lower recurrence rate of AF after RFCA.
冠状动脉疾病(CAD)血运重建与消融术后房颤(AF)复发事件发生率之间的关系尚不清楚。本研究旨在探讨接受射频导管消融(RFCA)的患者冠状动脉血运重建与房颤复发之间的关系。本研究纳入了419例在进行RFCA的同时接受冠状动脉造影的患者。阻塞性CAD定义为至少一支冠状动脉血管狭窄≥75%,并建议进行经皮冠状动脉介入治疗(PCI)。非阻塞性CAD定义为冠状动脉血管狭窄<75%。终点是在24个月随访期间RFCA术后无房颤复发。总共有102例、95例和212例患者分别接受了冠状动脉造影,并被诊断为患有阻塞性CAD、非阻塞性CAD和非CAD。在24个月的随访期内,无阻塞性CAD的患者比有阻塞性CAD的患者更有可能实现无房颤(风险比[HR]:1.72;95%置信区间[CI]:1.23 - 2.41;P = 0.001)。接受PCI的患者房颤复发率明显低于未接受PCI的患者(HR:0.45;95% CI:0.25 - 0.80;P = 0.007)。多因素回归分析显示,阻塞性CAD患者房颤复发的其他预测因素是多支血管狭窄(HR:1.92;95% CI:1.04 - 3.54;P = 0.036)和左心房直径(HR:2.56;95% CI:1.31 - 5.00;P = 0.006)。本研究表明,阻塞性CAD与较高的房颤复发率相关。此外,对于CAD患者,冠状动脉血运重建与RFCA术后较低的房颤复发率相关。