Guizhou Medical University, Guiyang, Guizhou, China.
Department of Ultrasound Center, The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China.
Echocardiography. 2024 Mar;41(3):e15779. doi: 10.1111/echo.15779.
Radiofrequency catheter ablation (RFCA) is an effective method for controlling the heart rate of paroxysmal atrial fibrillation (PAF). However, recurrence is trouble under the RFCA. To gain a deeper understanding of the risk factors for recurrence in patients, we created a nomogram model to provide clinicians with treatment recommendations.
A total of two hundred thirty-three patients with PAF treated with RFCA at Guizhou Medical University Hospital between January 2021 and December 2022 were consecutively included in this study, and after 1 year of follow-up coverage, 166 patients met the nadir inclusion criteria. Patients with AF were divided into an AF recurrence group and a non-recurrence group. The nomogram was constructed using univariate and multivariate logistic regression analyses. By calculating the area under the curve, we analyzed the predictive ability of the risk scores (AUC). In addition, the performance of the nomogram in terms of calibration, discrimination, and clinical utility was evaluated.
At the 12-month follow-up, 48 patients (28.92%) experienced a recurrence of AF after RFCA, while 118 patients (71.08%) maintained a sinus rhythm. In addition to age, sex, and TRV, LAD, and TTPG were independent predictors of recurrence of RFCA. The c-index of the nomogram predicted AF recurrence with an accuracy of .723, showing good decision curves and a calibrated nomogram, as determined by internal validation using a bootstrap sample size of 1000.
We created a nomogram based on multifactorial logistic regression analysis to estimate the probability of recurrence in patients with atrial fibrillation 1 year after catheter ablation. This plot can be utilized by clinicians to predict the likelihood of recurrence.
射频导管消融（RFCA）是控制阵发性心房颤动（PAF）心率的有效方法。然而，RFCA 后复发是个麻烦。为了更深入地了解患者复发的危险因素，我们创建了一个列线图模型，为临床医生提供治疗建议。
连续纳入 2021 年 1 月至 2022 年 12 月在贵州医科大学附属医院接受 RFCA 治疗的 233 例 PAF 患者，随访 1 年，符合最低纳入标准的患者 166 例。将 AF 患者分为 AF 复发组和非复发组。采用单因素和多因素逻辑回归分析构建列线图。通过计算曲线下面积，分析风险评分（AUC）的预测能力。此外，还评估了列线图的校准、判别和临床实用性。
在 12 个月的随访中，48 例（28.92%）患者在 RFCA 后出现 AF 复发，118 例（71.08%）患者维持窦性节律。除年龄、性别外，TRV、LAD 和 TTPG 是 RFCA 复发的独立预测因素。列线图预测 AF 复发的 c 指数准确性为 0.723，通过使用 bootstrap 样本量为 1000 的内部验证，显示出良好的决策曲线和校准列线图。
我们基于多因素逻辑回归分析创建了一个列线图，以估计导管消融 1 年后心房颤动患者复发的概率。临床医生可以使用该图预测复发的可能性。
