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持续性心房颤动射频导管消融术后三尖瓣反流改善的预测因素和结果。

Predictors and outcomes of tricuspid regurgitation improvement after radiofrequency catheter ablation for persistent atrial fibrillation.

机构信息

Division of Cardiology, Osaka Rosai Hospital, Osaka, Japan.

出版信息

J Cardiovasc Electrophysiol. 2023 Jun;34(6):1360-1366. doi: 10.1111/jce.15919. Epub 2023 May 7.

Abstract

INTRODUCTION

Little has been reported on the predictors and outcomes of improvement of tricuspid regurgitation (TR) after radiofrequency catheter ablation (RFCA) for persistent atrial fibrillation (AF).

METHODS

We enrolled 141 patients with persistent AF and moderate or severe TR assessed by transthoracic echocardiography (TTE) who underwent an initial RFCA between February 2015 and August 2021. These patients underwent follow-up TTE at 12 months after the RFCA, and were categorized into two groups based on the improvement (defined as at least one-grade improvement of TR) and non-improvement of TR: IM group and Non-IM group, respectively. We compared the patient characteristics, ablation procedures, and recurrences after the RFCA between the two groups. In addition, we examined the major event (defined as admission for heart failure or all-cause death) more than 12 months after the RFCA.

RESULTS

IM group consisted of 90 patients (64%). A multivariate analysis revealed that age <71 years old and absence of late recurrence (LR, defined as recurrence of atrial tachyarrhythmia between 3 and 12 months after the RFCA) were independently associated with the improvement of TR after the RFCA. Furthermore, IM group had the higher incidence of major event-free survival than Non-IM group.

CONCLUSIONS

Relatively young age and absence of LR were good predictors of improvement of TR after the RFCA for persistent AF. In addition, the improvement of TR was related to better clinical outcomes.

摘要

简介

关于持续性心房颤动(AF)射频导管消融(RFCA)后三尖瓣反流(TR)改善的预测因素和结果,鲜有报道。

方法

我们纳入了 141 例经胸超声心动图(TTE)评估为持续性 AF 合并中度或重度 TR 的患者,这些患者于 2015 年 2 月至 2021 年 8 月期间首次接受了 RFCA。这些患者在 RFCA 后 12 个月接受了随访 TTE,并根据 TR 的改善(定义为 TR 至少改善一个等级)和未改善(Non-IM 组)分为两组:IM 组和 Non-IM 组。我们比较了两组患者的特征、消融程序和 RFCA 后的复发情况。此外,我们检查了 RFCA 后 12 个月以上的主要事件(定义为因心力衰竭或全因死亡入院)。

结果

IM 组包括 90 例患者(64%)。多变量分析显示,年龄<71 岁和无晚期复发(LR,定义为 RFCA 后 3 至 12 个月发生的房性心动过速复发)与 RFCA 后 TR 的改善独立相关。此外,IM 组的主要事件无事件生存率高于 Non-IM 组。

结论

相对较年轻的年龄和无 LR 是 RFCA 治疗持续性 AF 后 TR 改善的良好预测因素。此外,TR 的改善与更好的临床结果相关。

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