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临床表型与导管消融术后心房颤动复发:一项无监督聚类分析。

Clinical Phenotypes and Atrial Fibrillation Recurrences After Catheter Ablation: An Unsupervised Cluster Analysis.

机构信息

Service de Cardiologie, Centre Hospitalier Régional Universitaire et Faculté de Médecine de Tours, Tours, France; Service de Cardiologie, Centre Hospitalier Régional Universitaire d'Orléans, Orléans, France; EA4245, Transplantation Immunité Inflammation, Université de Tours, Tours, France; Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart and Chest Hospital, Liverpool, UK.

Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart and Chest Hospital, Liverpool, UK.

出版信息

Curr Probl Cardiol. 2023 Aug;48(8):101732. doi: 10.1016/j.cpcardiol.2023.101732. Epub 2023 Mar 31.

Abstract

Catheter ablation (CA) is a well-established treatment of atrial fibrillation (AF). Data-driven cluster analysis is able to better distinguish prognostically-relevant phenotype clusters among patients with AF. We performed a hierarchical cluster analysis in a cohort of AF patients undergoing a first CA and evaluate associations between identified clusters and recurrences of arrhythmia following ablation. The study included 209 AF patients treated with CA. A total of 3 clusters with distinct characteristics were identified. Recurrences at 1 year occurred in 27.2% in Cluster 1, 43.2% in Cluster 2 and 60.9% in Cluster 3 (P < 0.0001). Cluster classification was independently associated with arrhythmia recurrences (HR 1.58, 95% CI 1.01-2.49, P = 0.046) after adjustment for age, CHADS-VASc score, left atrial volume, type of atrial fibrillation and ejection fraction. To concluded, cluster analysis identified 3 statistically-driven groups among AF patients treated with CA with different risks for arrhythmia recurrences.

摘要

导管消融 (CA) 是治疗心房颤动 (AF) 的一种成熟方法。基于数据的聚类分析能够更好地区分 AF 患者中具有预后相关性的表型聚类。我们对接受首次 CA 的 AF 患者队列进行了层次聚类分析,并评估了所识别的聚类与消融后心律失常复发之间的关系。该研究纳入了 209 例接受 CA 治疗的 AF 患者。确定了具有不同特征的 3 个聚类。在第 1 年时,聚类 1 中复发率为 27.2%,聚类 2 中为 43.2%,聚类 3 中为 60.9%(P<0.0001)。聚类分类在调整年龄、CHADS-VASc 评分、左心房容积、房颤类型和射血分数后,与心律失常复发独立相关(HR 1.58,95%CI 1.01-2.49,P=0.046)。综上所述,聚类分析在接受 CA 治疗的 AF 患者中确定了 3 个具有统计学意义的组,这些组的心律失常复发风险不同。

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