孤立性心房颤动导管消融术后复发相关因素的研究  

Study on the related factors of recurrence after catheter ablation of lone atrial fibrillation

作　　者：刘伟[1] 周建华[1] 谢东君 袁晓燕 LIU Wei;ZHOU Jianhua;XIE Dongjun;YUAN Xiaoyan(Department of Cardiology,Weihai Center Hospital Affiliated to Weifang Medical College,Weihai,Shandong 264400,China;Department of Clinical Medicine,Weifang MedicalCollege,Weifang,Shandong 261053,China)

机构地区：[1]潍坊医学院附属威海市中心医院心内科,山东威海264400 [2]潍坊医学院临床医学系,山东潍坊261053

出　　处：《安徽医药》2019年第5期906-909,共4页Anhui Medical and Pharmaceutical Journal

摘　　要：目的探讨临床基线资料对孤立性房颤射频消融术后复发的影响。方法连续入选2011年1月1日至2016年1月31日潍坊医学院附属威海市中心医院就诊的孤立性心房颤动128例,且均为首次行房颤射频消融术者。术前收集病人年龄、性别、房颤病程、房颤类型、超敏C反应蛋白、血清球蛋白、左心房前后径、左心室射血分数、术后是否行电复律等临床基线资料。经门诊或住院随访病人心电图、24 h动态心电图、心脏超声等以明确病人术后复发情况。结果经过(14.33±5.49)个月随访,单因素分析示房颤病程(OR=1.008,95%CI:1.003～1.013,P=0.001)、房颤类型(OR=0.432,95%CI:0.191～0.973,P=0.043)、左房前后径(OR=1.114,95%CI:1.027～1.207,P=0.009)与房颤射频消融术后复发显著相关。COX多因回归素分析,房颤病程(OR=1.012,95%CI:1.002～1.016,P=0.009)为术后复发的独立危险因素。结论房颤病程为孤立性房颤消融术后复发的独立危险因素,房颤病程越长复发率越高。Objective To investigate the effect of clinical baseline data on recurrence of lone atrial fibrillation after radiofrequency catheter ablation.Methods One hundred and twenty-eight patients with lone atrial fibrillation(LAF)who were first treated with radiofrequency catheter ablation of atrial fibrillation in Weihai Center Hospital Affiliated to Weifang Medical College from Jan.1st,2011 to Jan.31st,2016 were consecutively enrolled.Baseline data such as age,sex,duration of AF,type of atrial fibrillation,hypersensitive C-reactive protein(hs-CRP),serum globulin,left atrial anteroposterior diameter,left ventricular ejection fraction(LVEF)and postoperative electrocardiogram(ECG)were collected before the operation.The ECG,24 hours dynamic ECG(Holter)and echocardiography of the patient were followed up to determine the recurrence of the patients.Results Univariate analysis showed that the duration of atrial fibrillation(OR=1.008,95%CI:1.003-1.013,P=0.001),the type of AF(OR=0.432,95%CI:0.191-0.973,P=0.043),the anterior as well as posterior diameter of left atrium(OR=1.114,95%CI:1.027-1.207,P=0.009)were significantly correlated with the recurrence after radiofrequency ablation of AF.The course of AF(OR=1.012,95%CI:1.002-1.016,P=0.009)was an independent risk factor of postoperative recurrence.Conclusion The duration of AF is an independent risk factor after lone atrial fibrillation ablation.The longer the duration of AF is,the higher the recurrence rate is.

关 键 词：心房颤动 导管消融术 C反应蛋白质 每搏输出量 心电描记术 电抗休克 

分 类 号：R541.75[医药卫生—心血管疾病]