Feng Xiu, Yang Ling, Yang Zhenni, Miao Yuxia, Gong Mingxia, Meng Jun, Xu Min
Department of Echocardiography and Cardiology, The Third Affiliated Hospital of Soochow University, 213000 Changzhou, Jiangsu, China.
Department of Cardiology, The Third Affiliated Hospital of Soochow University, 213000 Changzhou, Jiangsu, China.
Rev Cardiovasc Med. 2024 Nov 6;25(11):394. doi: 10.31083/j.rcm2511394. eCollection 2024 Nov.
Atrial fibrillation (AF) is the most common persistent arrhythmia, with increasing incidence worldwide. Transcatheter radiofrequency ablation (RFA) represents a first-line therapy for paroxysmal atrial fibrillation (PAF), although the long-term recurrence rate of AF remains relatively high. This study aimed to investigate the relationship between the average heart rate (AHR) on a dynamic electrocardiogram before transcatheter RFA and the postoperative recurrence of AF in patients with PAF.
A retrospective analysis was conducted on patients with PAF who experienced primary transcatheter RFA. Relevant clinical indicators, dynamic electrocardiograms, and echocardiography were collected from the enrolled patients before ablation. Multivariate logistic regression analysis examined the relationship between the preoperative AHR and postoperative recurrence of AF in patients with PAF.
This study included 224 patients with PAF who were scheduled for transcatheter RFA. Based on the AHR in sinus rhythm state on the dynamic electrocardiogram before ablation, the patients were divided into three groups: low, medium, and high heart rate. The recurrence rates of AF after ablation for the three groups were 14.667%, 8.108%, and 4.000%, respectively. After adjusting for confounding factors, postoperative AF recurrence risk gradually decreased with an increase in preoperative AHR (odds ratio: 0.849, 95% confidence interval: 0.729-0.988, = 0.035). This trend remained statistically significant even after adjusting for the three categorical variables of AHR (odds ratio = 0.025, 95% confidence interval: 0.001-0.742, = 0.033). The curve fitting analysis indicated a linear and negative correlation between the preoperative AHR and postoperative AF recurrence risk in patients with PAF.
In patients with PAF who experienced their primary transcatheter RFA, there was a linear and negative correlation between the AHR in sinus rhythm state on the preoperative dynamic electrocardiogram and the risk of postoperative AF recurrence.
心房颤动（AF）是最常见的持续性心律失常，在全球范围内发病率不断上升。经导管射频消融（RFA）是阵发性心房颤动（PAF）的一线治疗方法，尽管房颤的长期复发率仍然相对较高。本研究旨在探讨经导管RFA术前动态心电图平均心率（AHR）与PAF患者术后房颤复发之间的关系。
对接受初次经导管RFA的PAF患者进行回顾性分析。在消融前从纳入患者中收集相关临床指标、动态心电图和超声心动图。多因素logistic回归分析探讨PAF患者术前AHR与术后房颤复发之间的关系。
本研究纳入224例计划接受经导管RFA的PAF患者。根据消融前动态心电图窦性心律状态下的AHR，将患者分为三组：低心率、中等心率和高心率。三组消融后房颤复发率分别为14.667%、8.108%和4.000%。在调整混杂因素后，术后房颤复发风险随术前AHR的增加而逐渐降低（比值比：0.849，95%置信区间：0.729-0.988，P = 0.035）。即使在调整AHR的三个分类变量后，这种趋势仍具有统计学意义（比值比 = 0.025，95%置信区间：0.001-0.742，P = 0.033）。曲线拟合分析表明，PAF患者术前AHR与术后房颤复发风险之间存在线性负相关。
在接受初次经导管RFA的PAF患者中，术前动态心电图窦性心律状态下的AHR与术后房颤复发风险之间存在线性负相关。
