吸烟对肺静脉隔离后心房颤动复发的临床影响。

Clinical impact of smoking on atrial fibrillation recurrence after pulmonary vein isolation.

机构信息

Cardiology and Electrophysiology Unit, Department of Medical Specialties, Azienda USL Toscana Centro, Santa Maria Nuova Hospital, Florence, Italy.

Cardiology and Electrophysiology Unit, Department of Medical Specialties, Azienda USL Toscana Centro, Santa Maria Nuova Hospital, Florence, Italy; Department of Experimental and Clinical Medicine, University of Florence, Italy.

出版信息

Int J Cardiol. 2024 Oct 15;413:132342. doi: 10.1016/j.ijcard.2024.132342. Epub 2024 Jul 4.

DOI:10.1016/j.ijcard.2024.132342

PMID:38971534

Abstract

BACKGROUND

The clinical impact of smoking on atrial fibrillation (AF) recurrences after pulmonary vein isolation (PVI) have contradictory results in previous studies, performed on Asian populations.

METHODS AND AIM

Smoking habit and other cardiovascular risk-factors were assessed in patients who underwent their first radiofrequency PVI for symptomatic AF. The study aims to assess the clinical impact of smoking on AF recurrences after PVI in a contemporary European cohort of patients.

RESULTS

The study included 186 consecutive patients (135 males [72.6%]) with a mean age of 63.4 ± 9.7 years. Current smokers resulted 29 (15.7%). No statistically significant baseline differences were detected between current smokers and non-current smokers. After a follow-up of 418 ± 246 days, AF recurrence was higher in currently smoking patients vs. non-currently smoker patients, the latter intended as a combination between previous smokers and never smokers (34.5% vs. 14% p = 0.01). A previous smoking habit was not associated with increased risk of AF recurrence when compared with patients who never smoked (13.2% vs. 14.6%, p = 0.23), while a current smoking habit impacted on AF recurrence in comparison with previous smokers (p = 0.01) and never smokers (p = 0.04). The increased incidence of AF recurrence in current smokers was consistent also considering only paroxysmal AF (31.4% vs 9.6%, p = 0.012) or persistent AF (50% vs 31.2%, p = 0.03). Smoking (HR =2.96 95% CI 1.32-6.64) and persistent AF (HR =2.64 95% CI 1.22-5.7) resulted independent predictors of AF recurrence.

CONCLUSION

Cigarette smoking is associated with an increased risk of AF recurrences after PVI, both in paroxysmal and in persistent AF.

摘要

背景

在之前针对亚洲人群进行的研究中，吸烟对肺静脉隔离（PVI）后心房颤动（AF）复发的临床影响存在矛盾的结果。

方法和目的

在因症状性 AF 接受首次射频 PVI 的患者中评估吸烟习惯和其他心血管风险因素。本研究旨在评估吸烟对当代欧洲患者队列中 PVI 后 AF 复发的临床影响。

结果

该研究纳入了 186 例连续患者（135 例男性[72.6%]），平均年龄为 63.4±9.7 岁。目前吸烟者为 29 例（15.7%）。目前吸烟者和非吸烟者之间在基线时无统计学显著差异。在随访 418±246 天后，与非吸烟者相比，目前吸烟者的 AF 复发率更高，后者包括既往吸烟者和从不吸烟者（34.5%比 14%，p=0.01）。与从不吸烟者相比，既往吸烟史与 AF 复发风险增加无关（13.2%比 14.6%，p=0.23），而目前吸烟史与 AF 复发相关与既往吸烟者（p=0.01）和从不吸烟者（p=0.04）。在仅考虑阵发性 AF（31.4%比 9.6%，p=0.012）或持续性 AF（50%比 31.2%，p=0.03）时，目前吸烟者中 AF 复发的发生率也一致增加。吸烟（HR=2.96，95%CI 1.32-6.64）和持续性 AF（HR=2.64，95%CI 1.22-5.7）是 AF 复发的独立预测因素。