Alt E, Ammer R, Lehmann G, Pütter K, Ayers G M, Pasquantonio J, Schömig A
1. Medizinische Klinik, Klinikum rechts der Isar der Technischen, Universität München, Germany.
Am Heart J. 1997 Sep;134(3):419-25. doi: 10.1016/s0002-8703(97)70076-0.
The aim of this study was to identify predictors for recurrent atrial fibrillation after internal and external cardioversion in 157 patients. After cardioversion, patients were treated orally with sotalol (174 +/- 54 mg/day). Univariate predictors for recurrence included coronary artery disease (p < 0.05) and advanced age (p < 0.05). Multivariate adjusted risk for relapse increased with the presence of coronary artery disease (odds ratio [OR] 3.4, 95% confidence interval [CI] 1.6 to 8.0), presence of atrial fibrillation > 2 months before cardioversion (OR 2.3; 95% CI 1.4 to 4.5), left atrial diameter > 60 mm (OR 2.1; 95% CI 1.2 to 3.1), and age > 65 years (OR 1.6; 95% CI 1.3 to 3.3). In 26% of patients with lone atrial fibrillation, recurrence was observed compared with 51% of patients with underlying structural heart disease (p < 0.05). The mode of conversion, internal or external, had no impact on the recurrence rate. These findings might be useful for selection of the most appropriate therapy for the individual patient.
本研究旨在确定157例患者经体内和体外心脏复律后房颤复发的预测因素。心脏复律后，患者口服索他洛尔（174±54mg/天）进行治疗。复发的单因素预测因素包括冠状动脉疾病（p<0.05）和高龄（p<0.05）。复发的多因素调整风险随着冠状动脉疾病的存在（比值比[OR]3.4，95%置信区间[CI]1.6至8.0）、心脏复律前房颤持续>2个月（OR 2.3；95%CI 1.4至4.5）、左心房直径>60mm（OR 2.1；95%CI 1.2至3.1）以及年龄>65岁（OR 1.6；95%CI 1.3至3.3）而增加。在孤立性房颤患者中，26%出现复发，而有潜在结构性心脏病的患者中这一比例为51%（p<0.05）。复律方式，无论是体内还是体外，对复发率均无影响。这些发现可能有助于为个体患者选择最合适的治疗方法。
