摘要
目的分析射频消融手术对于持续性心房颤动(房颤)患者左心功能的影响及复发相关因素。方法选取2016年1月—2017年1月北京阜外医院心律失常中心收住持续性房颤接受射频消融治疗的患者60例,根据术后3个月以上随访结果分为房颤复发组(复发组,19例)和窦律维持组(窦律组,41例)。分别比较2组射频消融手术前后的左心功能指标改变,以及复发的危险因素。结果复发组患者较窦律组患者房颤持续时间明显延长,肺静脉隔离(CPVI)+其他消融比例高于窦律组(t=11.257,χ^(2)=2.121,P<0.01);消融后,窦律组血浆NT-proBNP下降高于复发组(t/P=2.988/0.004);和复发组相比,窦律组左心房内径缩小,左心室内径减小,LVEF增加,6 min步行试验距离增加更为明显,差异具有统计学意义(t=4.543,9.214,8.652,65.325,P<0.01);Logistic多因素回归分析显示,房颤持续时间(OR=1.23,95%CI 1.056~1.558,P=0.012)和术前超声心动图左心房内径大小(OR=2.01,95%CI 0.928~4.347,P=0.023)是消融术后房颤是否复发的预测因素。结论射频消融治疗持续性房颤后能够减少左心房内径和左心室内径,增加左心室射血分数,增加6 min步行试验距离,改善左心功能。术前左心房内径大、房颤持续时间长是持续性房颤射频消融术后复发的危险因素。
Objective To analyze the influence of radiofrequency ablation surgery on left ventricular function in patients with persistent atrial fibrillation(atrial fibrillation)and factors related to recurrence.Methods From January 2016 to January 2017,60 patients with persistent atrial fibrillation who received radiofrequency ablation were admitted to the Arrhythmia Center of Beijing Fuwai Hospital.According to the follow-up results of more than 3 months after operation,they were divided into atrial fibrillation recurrence group(recurrence group,19 cases)and sinus rhythm maintenance group(sinus rhythm group,41 cases).The changes of left ventricular function indexes before and after radiofrequency ablation and the risk factors of recurrence were compared between the two groups.Result The duration of atrial fibrillation in the recurrence group was significantly longer than that in the sinus rhythm group,and the ratio of pulmonary vein isolation(CPVI)+other ablation was higher than that in the sinus rhythm group(t=11.257,χ^(2)=2.121,P<0.01);after ablation,plasma in the sinus rhythm group The decrease of NT proBNP was higher than that of the recurrence group(t/P=2.988/0.004);compared with the recurrence group,the left atrial diameter decreased,the left ventricular diameter decreased,and the LVEF increased.The 6-minute walk test The increase in distance was more significant,and the difference was statistically significant(t=4.543,9.214,8.652,65.325,P<0.01);Logistic multivariate regression analysis showed that the duration of atrial fibrillation(OR=1.23,95%CI 1.056-1.558,P=0.012)and the left atrium diameter of preoperative echocardiogram(OR=2.01,95%CI 0.928-4.347,P=0.023)are the predictors of atrial fibrillation recurrence after ablation.Conclusion Radiofrequency ablation for persistent atrial fibrillation can reduce the left atrial diameter and left ventricular diameter,increase the left ventricular ejection fraction,increase the 6-minute walk test distance,and improve left ventricular function.The large inner diameter of the left atrium and long duration of atrial fibrillation before surgery are risk factors for recurrence after radiofrequency ablation of persistent atrial fibrillation.
作者
冯天捷
翁思贤
周彬
董潇男
于丰源
华伟
唐闽
Feng Tianjie;Weng Sixian;Zhou Bin;Dong Xiaonan;Yu Fengyuan;Hua Wei;Tang Min(Arrhythmia Center, National Center for Cardiovascular Disease and Fuwai Hospital, CAMS and PUMC, Beijing 100037, China)
出处
《疑难病杂志》
CAS
2021年第5期456-460,共5页
Chinese Journal of Difficult and Complicated Cases
基金
国家自然科学基金资助项目(61527811)。
关键词
心房颤动
持续性
射频消融
危险因素
复发
Atrial fibrillation,persistent
Radiofrequency ablation
Risk factor
Recurrence
