Ukita Kohei, Egami Yasuyuki, Kawanami Shodai, Sugae Hiroki, Kawamura Akito, Nakamura Hitoshi, Yasumoto Koji, Tsuda Masaki, Okamoto Naotaka, Matsunaga-Lee Yasuharu, Yano Masamichi, Nishino Masami, Tanouchi Jun
Division of Cardiology, Osaka Rosai Hospital, Osaka, Japan.
Division of Cardiology, Osaka Rosai Hospital, Osaka, Japan.
Am J Cardiol. 2023 Apr 15;193:97-101. doi: 10.1016/j.amjcard.2023.01.047. Epub 2023 Mar 9.
Little has been reported on the predictors of maintenance of sinus rhythm (SR) after radiofrequency catheter ablation (RFCA) for long-standing persistent atrial fibrillation (AF). We enrolled 151 patients with long-standing persistent AF (defined as AF lasting more than 12 months) who underwent an initial RFCA between October 2014 and December 2020 in our hospital. These patients were categorized into 2 groups on the basis of the absence and presence of the late recurrence (LR, defined as a recurrence of atrial tachyarrhythmia between 3 and 12 months after RFCA): SR group and LR group. The SR group comprised 92 patients (61%). In the univariate analysis, there were significant differences in gender and preprocedural average heart rate (HR) between the 2 groups (p = 0.042 and p = 0.042, respectively). A receiver operating characteristics analysis revealed that a cut-off value of preprocedural average HR to predict the maintenance of SR was 85 beats/min (sensitivity: 37%, specificity: 85%, area under curve: 0.58). A multivariate analysis showed that preprocedural average HR ≥85 beats/min was independently associated with the maintenance of SR after RFCA (odds ratio 3.30, 95% confidence interval 1.47 to 8.04, p = 0.003). In conclusion, a relatively high preprocedural average HR might be a prognostic factor of maintenance of SR after RFCA for long-standing persistent AF.
关于长期持续性心房颤动（AF）经导管射频消融（RFCA）后窦性心律（SR）维持的预测因素，此前报道较少。我们纳入了151例长期持续性AF患者（定义为AF持续超过12个月），这些患者于2014年10月至2020年12月在我院接受了首次RFCA。根据有无晚期复发（LR，定义为RFCA后3至12个月出现房性快速心律失常复发）将这些患者分为两组：SR组和LR组。SR组包括92例患者（61%）。单因素分析显示，两组之间在性别和术前平均心率（HR）方面存在显著差异（分别为p = 0.042和p = 0.042）。受试者工作特征分析显示，预测SR维持的术前平均HR临界值为85次/分钟（敏感性：37%，特异性：85%，曲线下面积：0.58）。多因素分析显示，术前平均HR≥85次/分钟与RFCA后SR的维持独立相关（比值比3.30，95%置信区间1.47至8.04，p = 0.003）。总之，相对较高的术前平均HR可能是长期持续性AF经RFCA后SR维持的一个预后因素。
