Geršak Borut, Podlogar Veronika, Prolič Kalinšek Tine, Jan Matevž
Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia.
Cardiovascular Surgery Department, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia.
J Clin Med. 2024 Sep 18;13(18):5508. doi: 10.3390/jcm13185508.
: 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.
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。