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非瓣膜性心房颤动患者射频导管消融术后晚期复发的危险因素。

Risk factors for late recurrence in patients with nonvalvular atrial fibrillation after radiofrequency catheter ablation.

机构信息

Department of Cardiology, The Affiliated Hospital of Qingdao University, Qingdao, China.

Department of Cardiac Ultrasound, The Affiliated Hospital of Qingdao University, Qingdao, China.

出版信息

Ann Noninvasive Electrocardiol. 2022 Mar;27(2):e12924. doi: 10.1111/anec.12924. Epub 2021 Dec 9.


DOI:10.1111/anec.12924
PMID:34882911
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8916568/
Abstract

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.

摘要

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/895b/8916568/959eac709eb6/ANEC-27-e12924-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/895b/8916568/773602455d45/ANEC-27-e12924-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/895b/8916568/cb2367a8c7c7/ANEC-27-e12924-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/895b/8916568/959eac709eb6/ANEC-27-e12924-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/895b/8916568/773602455d45/ANEC-27-e12924-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/895b/8916568/cb2367a8c7c7/ANEC-27-e12924-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/895b/8916568/959eac709eb6/ANEC-27-e12924-g002.jpg

相似文献

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Risk factors for late recurrence in patients with nonvalvular atrial fibrillation after radiofrequency catheter ablation.

Ann Noninvasive Electrocardiol. 2022-3

[2]
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[3]
[Predictors of atrial fibrillation recurrence after catheter ablation in hypertrophic cardiomyopathy patients with atrial fibrillation].

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[4]
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[Left atrial appendage volume is a valuable predictor of atrial fibrillation recurrence after radiofrequency catheter ablation].

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[6]
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J Cardiovasc Electrophysiol. 2013-11

[7]
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[8]
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[9]
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[10]
Late outcome of surgical radiofrequency ablation for persistent valvular atrial fibrillation in China: a single-center study.

J Cardiothorac Surg. 2017-8-3

引用本文的文献

[1]
Predictive value of cardiac electrophysiological balance index for recurrent atrial fibrillation after ablation.

Rev Assoc Med Bras (1992). 2024-12-2

[2]
Predictive value of the left atrioventricular coupling index for recurrence after radiofrequency ablation of paroxysmal atrial fibrillation.

J Cardiothorac Surg. 2024-10-1

[3]
Factors influencing early recurrence of atrial fibrillation among elderly patients following radiofrequency catheter ablation and the impact of different antiarrhythmic regimens.

Front Med (Lausanne). 2024-6-27

[4]
Development and Validation of a Risk Nomogram Model for Predicting Recurrence in Patients with Atrial Fibrillation After Radiofrequency Catheter Ablation.

Clin Interv Aging. 2022

[5]
Development and Validation of a Novel Prognostic Model Predicting the Atrial Fibrillation Recurrence Risk for Persistent Atrial Fibrillation Patients Treated with Nifekalant During the First Radiofrequency Catheter Ablation.

Cardiovasc Drugs Ther. 2023-12

本文引用的文献

[1]
Decreased estimated glomerular filtration rate predicts long-term recurrence after catheter ablation of atrial fibrillation in mild to moderate renal insufficiency.

BMC Cardiovasc Disord. 2021-10-21

[2]
Relationship Between Serum Albumin and Risk of Atrial Fibrillation: A Dose-Response Meta-Analysis.

Front Nutr. 2021-8-18

[3]
2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS): The Task Force for the diagnosis and management of atrial fibrillation of the European Society of Cardiology (ESC) Developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC.

Eur Heart J. 2021-2-1

[4]
Trends in excess mortality associated with atrial fibrillation over 45 years (Framingham Heart Study): community based cohort study.

BMJ. 2020-8-11

[5]
Recurrence of Atrial Fibrillation After Catheter Ablation or Antiarrhythmic Drug Therapy in the CABANA Trial.

J Am Coll Cardiol. 2020-6-30

[6]
Longer diagnosis-to-ablation time is associated with recurrence of atrial fibrillation after catheter ablation-Systematic review and meta-analysis.

J Arrhythm. 2019-12-27

[7]
Catheter Ablation of Atrial Fibrillation: State of the Art and Future Perspectives.

Cardiol Ther. 2020-6

[8]
Alcohol Abstinence in Drinkers with Atrial Fibrillation.

N Engl J Med. 2020-1-2

[9]
Effect of Heart Rate on Stroke Recurrence and Mortality in Acute Ischemic Stroke With Atrial Fibrillation.

Stroke. 2019-12-4

[10]
Serum albumin and atrial fibrillation: insights from epidemiological and mendelian randomization studies.

Eur J Epidemiol. 2019-11-18

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