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心脏电生理平衡指数对消融术后房颤复发的预测价值

Predictive value of cardiac electrophysiological balance index for recurrent atrial fibrillation after ablation.

作者信息

Yao Weifeng, Shi Gengling, Liu Yunfei, Dai Xixi, Wu Yang

机构信息

Shanghai Baoshan District Wusong Central Hospital, Department of Cardiovascular Medicine - Shanghai, China.

出版信息

Rev Assoc Med Bras (1992). 2024 Dec 2;70(12):e20240875. doi: 10.1590/1806-9282.20240875. eCollection 2024.

Abstract

OBJECTIVE

This study aimed to evaluate the prognostic significance of the cardiac electrophysiological balance index in predicting the recurrence of atrial fibrillation following radiofrequency ablation.

METHODS

Patients with paroxysmal atrial fibrillation undergoing radiofrequency ablation were enrolled from July 2021 to March 2023 and categorized into recurrence and non-recurrence groups based on postoperative atrial fibrillation recurrence during a 6- to 12-month follow-up. Clinical and electrocardiogram data at admission were collected, and cardiac electrophysiological balance index was calculated. Multivariate logistic regression analysis identified independent factors contributing to atrial fibrillation recurrence. Receiver operating characteristic curves assessed predictive values.

RESULTS

Among 127 subjects, 36 experienced postoperative recurrence (22 paroxysmal atrial fibrillation, 10 atrial flutter, and 4 atrial tachycardia). Significant differences in hypersensitive C-reactive protein levels, QT, QRS, and cardiac electrophysiological balance index were observed between recurrent and non-recurrent groups. Multivariate analysis revealed cardiac electrophysiological balance index as an independent risk factor for recurrence (OR 1.766, 95%CI 1.415-2.204, p<0.001). Receiver operating characteristic curve analysis showed cardiac electrophysiological balance index's predictive value with an area under the curve of 0.865 (95%CI 0.807-0.923, p<0.001), and a cutoff value of 4.3 demonstrated a sensitivity of 87.67% and a specificity of 71.23%.

CONCLUSIONS

The cardiac electrophysiological balance index emerges as a non-invasive tool with substantial predictive value for estimating the likelihood of paroxysmal AF recurrence post-ablation.

摘要

目的

本研究旨在评估心脏电生理平衡指数在预测射频消融术后房颤复发中的预后意义。

方法

选取2021年7月至2023年3月接受射频消融的阵发性房颤患者,根据术后6至12个月随访期间房颤复发情况分为复发组和未复发组。收集入院时的临床和心电图数据,并计算心脏电生理平衡指数。多因素逻辑回归分析确定房颤复发的独立因素。绘制受试者工作特征曲线评估预测价值。

结果

127例受试者中,36例术后复发(22例阵发性房颤、10例房扑和4例房性心动过速)。复发组和未复发组在超敏C反应蛋白水平、QT、QRS及心脏电生理平衡指数方面存在显著差异。多因素分析显示心脏电生理平衡指数是复发的独立危险因素(OR 1.766,95%CI 1.415 - 2.204,p<0.001)。受试者工作特征曲线分析显示心脏电生理平衡指数的预测价值,曲线下面积为0.865(95%CI 0.807 - 0.923,p<0.001),截断值为4.3时,敏感性为87.67%,特异性为71.23%。

结论

心脏电生理平衡指数是一种无创工具,对估计消融术后阵发性房颤复发可能性具有重要预测价值。

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