Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, Xinquan Road 29, 350001, Fuzhou, Fujian, P. R. China.
Fujian Medical University, Fuzhou, Fujian, P. R. China.
BMC Pulm Med. 2024 Sep 20;24(1):467. doi: 10.1186/s12890-024-03231-2.
To identify independent predictors of late recurrence of atrial fibrillation (AF) after surgical ablation in patients undergoing rheumatic valve surgery.
A total of 258 patients who underwent surgical ablation for AF with rheumatic heart disease at our hospital between January 2019 and June 2022 were retrospectively included. The patients were followed up for 12 months. Late recurrence was defined as any AF recurrence longer than 30 s between 3 and 12 months. Patients with or without late recurrence were divided into non-recurrence and recurrence groups. Univariate and multivariate analyses were performed to identify the predictors of late recurrence.
The in-hospital mortality rate was 0.8% (2/258), and the late recurrence rate of AF was 38.4%, including 152 and 95 cases in the non-recurrent and recurrent groups respectively, with a follow-up completion rate of 96.5% (247/256). There were no deaths during follow-up, two patients (0.8%) experienced a stroke, and one patient (0.4%) experienced gastrointestinal hemorrhage. The results of the univariate and multivariate analyses of the preoperative risk factors for late recurrence showed a left atrial (LA) anteroposterior diameter ≥ 52.9 mm (odds ratio [OR] = 2.366, 95% confidence interval [CI] = 1.089-5.138, P = 0.030], ratio of the superoinferior to the anteroposterior diameters of LA (S-AR) < 1.19 (OR = 4.639, 95% CI = 2.181-9.865, P < 0.001), and AF duration ≥ 39 months (OR = 6.152, 95% CI = 2.897-13.061, P < 0.001), and cardiothoracic ratio ≥ 0.63 (OR = 2.716, 95% CI = 1.314-5.612, P = 0.007) were the most significant independent risk factors.
LA anteroposterior diameter ≥ 52.9 mm, S-AR < 1.19, and AF duration ≥ 36 months and cardiothoracic ratio ≥ 0.63 are independent predictors for late recurrence of AF after surgical ablation in patients undergoing rheumatic valve surgery.
确定风湿性心脏瓣膜病患者行心脏外科手术后房颤（AF）消融术后晚期复发的独立预测因素。
回顾性纳入 2019 年 1 月至 2022 年 6 月期间在我院行 AF 消融术治疗的风湿性心脏病患者 258 例。对患者进行 12 个月的随访。晚期复发定义为 3 至 12 个月之间任何超过 30s 的 AF 复发。将有无晚期复发的患者分为无复发组和复发组。采用单因素和多因素分析确定晚期复发的预测因素。
住院死亡率为 0.8%（2/258），AF 晚期复发率为 38.4%，无复发组和复发组分别为 152 例和 95 例，随访完成率为 96.5%（247/256）。随访期间无死亡病例，2 例（0.8%）发生脑卒中，1 例（0.4%）发生胃肠道出血。对晚期复发的术前危险因素进行单因素和多因素分析，结果显示左心房（LA）前后径≥52.9mm（比值比[OR]：2.366，95%置信区间[CI]：1.089-5.138，P=0.030），LA 上下径与前后径比值（S-AR）＜1.19（OR：4.639，95%CI：2.181-9.865，P＜0.001），AF 持续时间≥39 个月（OR：6.152，95%CI：2.897-13.061，P＜0.001）和心胸比≥0.63（OR：2.716，95%CI：1.314-5.612，P=0.007）是最显著的独立危险因素。
LA 前后径≥52.9mm、S-AR＜1.19、AF 持续时间≥36 个月和心胸比≥0.63是风湿性心脏瓣膜病患者行心脏外科手术后房颤消融术后晚期复发的独立预测因素。
