阵发性心房颤动患者射频消融术后3天内复发的危险因素研究  

Risk Factors for the Recurrence of Paroxysmal Atrial Fibrillation Within 3 Days After Radiofrequency Ablation

作　　者：南京[1,2] 黄景玲[1,2] 杨水祥[1,2] 

机构地区：[1]首都医科大学附属北京世纪坛医院心血管内科,北京市100038 [2]北京大学第九临床医学院

出　　处：《中国全科医学》2016年第14期1633-1637,共5页Chinese General Practice

摘　　要：目的回顾性分析阵发性心房颤动(房颤)患者射频消融术后3 d内房颤复发的危险因素。方法选取2012-01-01至2014-07-31于北京世纪坛医院心血管内科住院诊治并接受射频消融术治疗的阵发性房颤患者147例,在CARTO三维标测系统指导下进行射频消融术治疗,术后心电监护3 d,观察房颤是否复发,并分为房颤复发组(Af组)和非房颤复发组(NAf组)。同时根据复发时间长短将Af组患者分为4个亚组:A亚组(30 s≤复发时间<3min),B亚组(3 min≤复发时间<30 min),C亚组(30 min≤复发时间<3 h),D亚组(复发时间≥3 h)。分析房颤复发的危险因素。结果房颤复发患者共23例(15.6%)。单因素分析结果显示:两组患者高血压患病率、病程、超敏C反应蛋白(hs-CRP)、左心室射血分数(LVEF)、左心房舒张末期内径(LAEDD)、单纯环肺静脉隔离消融(PVI)术式采用率比较,差异均有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,高血压、病程、LVEF、LAEDD、单纯PVI术式是房颤复发的影响因素(P<0.05)。4个亚组高血压患病率、病程、hs-CRP、LAEDD、单纯PVI术式采用率比较,差异均无统计学意义(P>0.05);4亚组LVEF比较,差异有统计学意义(P<0.05)。结论合并高血压、病程较长、LVEF下降、LAEDD增加、单纯应用PVI术式为阵发性房颤患者射频消融术后住院期间房颤复发的独立危险因素。Objective To conduct a retrospective analysis on the risk factors for the recurrence of paroxysmal atrial fibrillation within 3 days after radiofrequency ablation. Methods From January 1,2012 to July 31,2014,we recruited 147 patients with paroxysmal atrial fibrillation who were hospitalized and received radiofrequency ablation in the Department of Cardiology of Beijing Shijitan Hospital. Radiofrequency ablation was undertaken by the guidance of CARTO. After surgery,electrocardiograph monitoring was conducted for 3 days to observe whether atrial fibrillation relapsed, and the patients were assigned into Af group and NAf group. According to the duration of relapse,the patients were divided into 4 subgroups： subgroup A（ 30 s≤time duration 3 min）,subgroup B（ 3 min≤time duration 30 min）,subgroup C（ 30 min≤time duration 3 h）,subgroup D（ time duration≥3 h）. Risk factors for atrial fibrillation recurrence were analyzed. Results There were 23 patients（ 15. 6%） in Af group. Univariate analysis showed that the two groups were significantly different in the prevalence of hypertension,duration of disease,hs-CRP,LVEF,LAEDD and the rate of sole application of PVI（ P 〈 0. 05）. Multivariate Logistic regression analysis showed that the hypertension,duration of disease,LVEF,LAEDD,and the sole application of PVI were influencing factors for atrial fibrillation（ P 〈 0. 05）. The 4 subgroups were not significantly different in prevalence of hypertension,duration of disease, hs-CRP, LAEDD, and the sole application of PVI（ P 〈 0. 05）; the 4 subgroups were significantly different in LVEF（ P 〈 0. 05）. Conclusion Complication of hypertension, the long disease duration, the decrease in LVEF,the increase of LAEDD and the sole application of PVI are independent risk factors for the recurrence of atrial fibrillation of hospitalized patients after radiofrequency ablation.

关 键 词：心房颤动 导管消融术 复发 危险因素 

分 类 号：R541.75[医药卫生—心血管疾病]