Department of Cardiology, The Affiliated Hospital of Qingdao University, Qingdao, China.
Department of Cardiac Ultrasound, The Affiliated Hospital of Qingdao University, Qingdao, China.
Ann Noninvasive Electrocardiol. 2022 Mar;27(2):e12924. doi: 10.1111/anec.12924. Epub 2021 Dec 9.
OBJECTIVE: To identify the risk factors for postoperative atrial fibrillation (AF) recurrence in nonvalvular AF patients undergoing radiofrequency catheter ablation (CA).
METHODS: We retrospectively reviewed the data from 426 of 450 AF patients who underwent CA. Patients were divided into two groups according to recurrence after the operation; the risk factors for AF recurrence were analyzed. A stratification system for lesions was created based on the cutoff of the risk factors; the associations among the subgroups and the AF recurrence rate were analyzed.
RESULTS: AF recurrence occurred in 98 (23.0%) patients. Univariate analysis demonstrated that AF type, hypertrophic cardiomyopathy, left atrial diameter (LAD), left ventricular ejection fraction (LVEF), serum albumin, and D-dimer concentrations were associated with AF recurrence. AF type (OR =2.907, p < .001), serum albumin concentration (OR =1.112, p < .05), and LAD (OR =1.115, p < .001) were independent risk factors for AF recurrence. The area under the ROC curve of LAD for the prediction of AF recurrence was 0.722 (95% CI: 0.6640.779) and that of serum albumin for the prediction of AF recurrence was 0.608 (95% CI: 0.5450.672). Further stratification revealed that patients with persistent or paroxysmal AF with LAD ≥43.5 mm and serum albumin concentration ≥42.2 g/L had a higher rate of AF recurrence than the reference group.
CONCLUSION: Atrial fibrillation type, LAD, and serum albumin concentration are risk factors for AF recurrence after CA in patients with nonvalvular AF. Patients with persistent AF with LAD ≥43.5 mm and serum albumin concentration ≥42.2 g/L have a higher risk of late AF recurrence after surgery.
目的:确定行射频导管消融术(CA)的非瓣膜性房颤(AF)患者术后房颤复发的危险因素。
方法:我们回顾性分析了 450 例 AF 患者中 426 例的资料。根据术后是否复发,患者被分为两组;分析了房颤复发的危险因素。基于危险因素的截断值,建立了病变分层系统;分析了亚组之间的关联和房颤复发率。
结果:98 例(23.0%)患者发生房颤复发。单因素分析表明,房颤类型、肥厚型心肌病、左心房直径(LAD)、左心室射血分数(LVEF)、血清白蛋白和 D-二聚体浓度与房颤复发有关。房颤类型(OR=2.907,p<0.001)、血清白蛋白浓度(OR=1.112,p<0.05)和 LAD(OR=1.115,p<0.001)是房颤复发的独立危险因素。LAD 预测房颤复发的 ROC 曲线下面积为 0.722(95%CI:0.6640.779),血清白蛋白预测房颤复发的曲线下面积为 0.608(95%CI:0.5450.672)。进一步分层显示,LAD≥43.5mm 且血清白蛋白浓度≥42.2g/L 的持续性或阵发性房颤患者,房颤复发率高于参考组。
结论:在非瓣膜性房颤患者中,房颤类型、LAD 和血清白蛋白浓度是 CA 后房颤复发的危险因素。持续性房颤且 LAD≥43.5mm 及血清白蛋白浓度≥42.2g/L 的患者术后晚期房颤复发风险较高。
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