Department of Cardiology, Chongming Hospital Affiliated to Shanghai University of Medicine and Health Sciences, Shanghai, China.
Ann Noninvasive Electrocardiol. 2023 Jan;28(1):e13031. doi: 10.1111/anec.13031. Epub 2022 Dec 19.
To compare the effects of different intervention measures on prognosis and quality of life in patients with atrial fibrillation, in order to provide clinical basis for diagnosis and treatment.
A total of 160 patients who visited several hospitals including Shanghai Xinhua Hospital from June 2019 to June 2021 were selected. Among them, 40 cases were in the drug treatment group (DRUG group), 40 cases in the radiofrequency ablation group (Radiofrequency ablation, RFA group), and 40 cases in the catheter ablation combined with percutaneous left atrial appendage occlusion group (""one-stop"" procedure group) and 40 cases in the percutaneous left atrial appendage closure group (Left atrial appendage closure, LAAC group). The Minnesota quality of life score (MLHFQ), ejection fraction (LVEF), and left atrial anterior and posterior diameters (LAD) were compared between the groups at 1-year follow-up, and the differences in adverse events were compared between the groups.
(1) After a 1-year follow-up, overall comparison, the MLHFQ scores and the LVEF and the LAD among the four groups were statistically different (p < .01); (2) Multiple comparisons, ① the MLHFQ scores: The RFA group was the lowest, the "one-stop" operation group was lower than the DRUG group, the LAAC group was the highest (p < .01). ② LVEF: The RFA group was the highest, the "one-stop" procedure group was higher than the drug treatment group, the LAAC group was the lowest (p < .01). ③ LAD: the RFA group and the "one-stop" procedure group were smaller than the DRUG group, the DRUG group was smaller than the LAAC group (p < .01).(3) Compared with the baseline data after 1-year follow-up in each group, in the RFA group and in the "one-stop" procedure group, the MLHFQ scores was decreased, the LVEF was increased, and the LAD was decreased (p < .01); in the DRUG group: the difference was not statistically significant (p > .05); in the LAAC group, the MLHFQ scores was increased, the LVEF was decreased, and the LAD was increased (p < .01). (4) There were significant differences in the incidence of adverse events among the four groups (p < .01), the lowest in the RFA group and the highest in the LAAC group.
Compared with drug treatment, radiofrequency ablation and "one-stop" procedure group can improve the quality of life of patients with atrial fibrillation, improve cardiac function, and reduce the occurrence of adverse events. Percutaneous left atrial appendage occlusion affects patients' quality of life and improves cardiac function, and increases the incidence of adverse events.
比较不同干预措施对心房颤动患者预后和生活质量的影响，为临床诊断和治疗提供依据。
选取 2019 年 6 月至 2021 年 6 月在上海新华医院等多家医院就诊的 160 例患者为研究对象，其中药物治疗组（DRUG 组）40 例、射频消融组（Radiofrequency ablation，RFA 组）40 例、导管消融联合经皮左心耳封堵“一站式”手术组（“一站式”手术组）40 例、经皮左心耳封堵组（Left atrial appendage closure，LAAC 组）40 例。比较各组患者 1 年随访时的明尼苏达生活质量评分（Minnesota quality of life score，MLHFQ）、射血分数（left ventricular ejection fraction，LVEF）、左心房前后径（left atrial anterior and posterior diameters，LAD），比较各组不良事件的差异。
（1）1 年随访时，各组间整体比较，MLHFQ 评分及 LVEF、LAD 比较差异均有统计学意义（p<0.01）；（2）多重比较，①MLHFQ 评分：RFA 组最低，“一站式”手术组低于药物治疗组，LAAC 组最高（p<0.01）。②LVEF：RFA 组最高，“一站式”手术组高于药物治疗组，LAAC 组最低（p<0.01）。③LAD：RFA 组、“一站式”手术组小于药物治疗组，药物治疗组小于 LAAC 组（p<0.01）。（3）与各组患者 1 年随访时的自身基线数据比较，RFA 组和“一站式”手术组 MLHFQ 评分降低，LVEF 升高，LAD 降低（p<0.01）；药物治疗组：差异无统计学意义（p>0.05）；LAAC 组 MLHFQ 评分升高，LVEF 降低，LAD 升高（p<0.01）。（4）四组患者不良事件发生率比较差异有统计学意义（p<0.01），RFA 组发生率最低，LAAC 组发生率最高。
与药物治疗相比，射频消融术和“一站式”手术组可改善心房颤动患者的生活质量，改善心功能，减少不良事件的发生。经皮左心耳封堵术影响患者生活质量，改善心功能，增加不良事件的发生。
