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心房颤动汇聚手术的长期预后

Long-Term Outcomes after Convergent Procedure for Atrial Fibrillation.

作者信息

Geršak Borut, Podlogar Veronika, Prolič Kalinšek Tine, Jan Matevž

机构信息

Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia.

Cardiovascular Surgery Department, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia.

出版信息

J Clin Med. 2024 Sep 18;13(18):5508. doi: 10.3390/jcm13185508.

Abstract

: The aim of this single-center retrospective study was to evaluate the long-term outcomes after the convergent procedure (CP) for treatment of AF. : We analyzed the outcomes of patients that underwent CP from January 2009 until July 2020. A total of 119 patients with paroxysmal AF (23.5%), persistent AF (5.9%), or long-standing persistent AF (70.6%) that attended long-term follow-up were included. The outcomes were assessed 1 year after the CP and at long-term follow-up. At the 1-year follow-up, rhythm and AF burden were assessed for patients with an implantable loop recorder (61.2%). For others, rhythm was assessed by clinical presentation and 12-lead ECG. At long-term follow-up, patients with sinus rhythm (SR) or an unclear history were assessed with a 7-day Holter ECG monitor, and AF burden was determined. Long-term success was defined as freedom from AF/atrial flutter (AFL) with SR on a 12-lead ECG and AF/AFL burden < 1% on the 7-day Holter ECG. : At 1-year follow-up, 91.4% of patients had SR and 76.1% of patients had AF/AFL burden < 1%. At long-term follow-up (8.3 ± 2.8 years), 65.5% of patients had SR and 53.8% of patients had AF/AFL burden < 1% on the 7-day Holter ECG. Additional RFAs were performed in 32.8% of patients who had AF or AFL burden < 1%. At long-term follow-up, age, body mass index, and left atrial volume index were associated with an increased risk of AF recurrence. : CP resulted in high long-term probability of SR maintenance. During long-term follow-up, additional RFAs were required to maintain SR in a substantial number of patients.

摘要

本单中心回顾性研究的目的是评估房颤(AF)消融手术(CP)后的长期疗效。我们分析了2009年1月至2020年7月期间接受CP治疗的患者的疗效。共有119例阵发性房颤(23.5%)、持续性房颤(5.9%)或长期持续性房颤(70.6%)患者接受了长期随访。在CP术后1年和长期随访时评估疗效。在1年随访时,对植入式循环记录仪的患者(61.2%)评估心律和房颤负荷。对于其他患者,通过临床表现和12导联心电图评估心律。在长期随访时,对窦性心律(SR)或病史不明的患者进行7天动态心电图监测,并确定房颤负荷。长期成功定义为12导联心电图显示SR且无房颤/心房扑动(AFL),7天动态心电图显示房颤/AFL负荷<1%。在1年随访时,91.4%的患者为SR,76.1%的患者房颤/AFL负荷<1%。在长期随访(8.3±2.8年)时,65.5%的患者为SR,53.8%的患者7天动态心电图显示房颤/AFL负荷<1%。房颤或AFL负荷<1%的患者中有32.8%接受了额外的射频消融术(RFA)。在长期随访时,年龄、体重指数和左心房容积指数与房颤复发风险增加相关。CP导致SR维持的长期概率较高。在长期随访期间,大量患者需要额外的RFA来维持SR。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bbd1/11432606/51a6bbf18c76/jcm-13-05508-g001.jpg

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