Ukita Kohei, Egami Yasuyuki, Nohara Hiroaki, Kawanami Shodai, Kawamura Akito, Yasumoto Koji, Okamoto Naotaka, Matsunaga-Lee Yasuharu, Yano Masamichi, Nishino Masami
Division of Cardiology, Osaka Rosai Hospital, Osaka, Japan.
Division of Cardiology, Osaka Rosai Hospital, Osaka, Japan.
Heart Rhythm. 2024 Oct 28. doi: 10.1016/j.hrthm.2024.10.053.
Little has been reported on the predictors of late recurrence (LR) after second radiofrequency catheter ablation (RFCA) for persistent atrial fibrillation (AF).
This study aimed to identify the predictors of LR after second RFCA in patients with persistent AF.
We retrospectively analyzed 123 patients who underwent a second RFCA because of LR after the initial RFCA for persistent AF. LR was defined as a recurrence of atrial tachyarrhythmia >3 months after the ablation procedure. The initial RFCA included pulmonary vein isolation alone or pulmonary vein isolation plus cavotricuspid isthmus block. The predictors of LR were evaluated by the Cox proportional hazards model.
In the univariate analysis, elevated brain natriuretic peptide levels, absence of pulmonary vein reconnections at the beginning of the second RFCA, and presence of early recurrence (ER, defined as a recurrence of atrial tachyarrhythmia within 3 months) after the second RFCA were associated with LR (P = .025, P = .018, and P < .001, respectively). The multivariate analysis revealed that absence of pulmonary vein reconnections and presence of ER were independent predictors of LR after the second RFCA (P = .004 and P < .001, respectively).
Absence of pulmonary vein reconnections and presence of ER were strongly associated with LR after the second RFCA in patients with persistent AF.
关于持续性心房颤动（AF）第二次射频导管消融（RFCA）术后晚期复发（LR）的预测因素报道较少。
本研究旨在确定持续性AF患者第二次RFCA术后LR的预测因素。
我们回顾性分析了123例因首次RFCA治疗持续性AF后发生LR而接受第二次RFCA的患者。LR定义为消融术后3个月以上房性快速性心律失常复发。首次RFCA包括单纯肺静脉隔离或肺静脉隔离加三尖瓣峡部阻滞。通过Cox比例风险模型评估LR的预测因素。
单因素分析显示，脑钠肽水平升高、第二次RFCA开始时无肺静脉重新连接以及第二次RFCA后存在早期复发（ER，定义为3个月内房性快速性心律失常复发）与LR相关（P分别为0.025、0.018和P<0.001）。多因素分析显示，无肺静脉重新连接和存在ER是第二次RFCA术后LR的独立预测因素（P分别为0.004和P<0.001）。
在持续性AF患者中，第二次RFCA术后无肺静脉重新连接和存在ER与LR密切相关。
