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基于功能性二尖瓣反流的阵发性心房颤动(PAF)后环肺静脉射频消融(CPVA)后复发预测模型。

A prediction model based on functional mitral regurgitation for the recurrence of paroxysmal atrial fibrillation (PAF) after post-circular pulmonary vein radiofrequency ablation (CPVA).

机构信息

Department of Electrocardiography, Wujin Hospital Affiliated with Jiangsu University, The Wujin Clinical college of Xuzhou Medical University, Changzhou, China.

Department of Cardiovascular Division, The Third Affiliated Hospital of Soochow University, Chang Zhou, China.

出版信息

Echocardiography. 2022 Dec;39(12):1501-1511. doi: 10.1111/echo.15479. Epub 2022 Nov 14.

Abstract

AIM

To construct a prediction model based on functional mitral regurgitation (FMR) in patients with paroxysmal atrial fibrillation (PAF) to predict atrial fibrillation recurrence after the post-circular pulmonary vein radiofrequency ablation (CPVA).

METHODS

We retrospectively analyzed 289 patients with PAF who underwent CPVA for the first time. The patients were randomly divided into modeling group and verification group at the ratio of 75:25. In the modeling group, the multivariate logistic regression was used to analyze and construct a prediction model for post-CPVA recurrence in PAF patients, which was then validated in the verification group.

RESULTS

(1) After 3-6 months of follow-up, the patients were divided into sinus rhythm group (252 cases) and recurrence group (24 cases); (2) In the modeling group, the age, left atrial diameter (LAD), and the degree of MR (mild, moderate, severe) were higher in recurrence group than that of the sinus rhythm group, and the left atrial appendage emptying velocity (LAAV) was lower in recurrence group (all p < .05). (3) A model for predicting the recurrence of PAF after radiofrequency ablation was constructed in the modeling group. The equation was: Logit(P) = -3.253 + .092 × age + 1.263 × mild MR + 2.325 × moderate MR + 5.111 × severe MR -.113 × LAAV. The area under the curve (AUC) of the model was .889 in modeling group and .866 in verification group, and the difference was not statistically significant (p > .05).

CONCLUSION

The prediction model of atrial fibrillation (AF) recurrence after CPVA in PAF patients has good predictive efficacy, specificity, and accuracy.

摘要

目的

构建基于阵发性心房颤动(PAF)患者功能性二尖瓣反流(FMR)的预测模型,以预测环肺静脉射频消融(CPVA)后心房颤动复发。

方法

我们回顾性分析了 289 例首次接受 CPVA 的 PAF 患者。患者按 75:25 的比例随机分为建模组和验证组。在建模组中,使用多变量逻辑回归分析构建 PAF 患者 CPVA 后复发的预测模型,然后在验证组中进行验证。

结果

(1)经过 3-6 个月的随访,患者分为窦性心律组(252 例)和复发组(24 例);(2)在建模组中,复发组的年龄、左心房直径(LAD)和 MR 程度(轻度、中度、重度)高于窦性心律组,左心耳排空速度(LAAV)低于复发组(均 P<.05)。(3)在建模组中构建了预测射频消融后 PAF 复发的模型。方程为:Logit(P)=-3.253+0.092×年龄+1.263×轻度 MR+2.325×中度 MR+5.111×重度 MR-.113×LAAV。模型在建模组中的曲线下面积(AUC)为 0.889,在验证组中的 AUC 为 0.866,差异无统计学意义(P>.05)。

结论

CPVA 后 PAF 患者心房颤动(AF)复发的预测模型具有良好的预测效能、特异性和准确性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eedf/10098807/56c89f3ad568/ECHO-39-1501-g002.jpg

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