老年心房颤动患者冷冻球囊消融术后复发相关影响因素分析  

Related influencing factors for recurrence in elderly atrial fibrillation patients after cryoballoon ablation

作　　者：宋文华 王乔 上官文锋[1] 缪帅[1] 赵志强[1] 刘恩照[1] 许纲[1] 李广平[1] 刘彤[1] Song Wenhua;Wang Qiao;Shangguan Wenfeng;Miao Shuai;Zhao Zhiqiang;Liu Enzhao;Xu Gang;Li Guangping;Liu Tong(Department of Cardiology,Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Diseases,Tianjin Institute of Cardiology,Second Hospital of Tianjin Medical University,Tianjin 300211,China)

机构地区：[1]天津医科大学第二医院心脏内科,天津市心血管病离子与分子机能重点实验室,天津心脏病学研究所,300211

出　　处：《中华老年心脑血管病杂志》2022年第12期1279-1282,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：国家自然科学基金(81970270)。

摘　　要：目的探讨冷冻球囊消融术治疗老年心房颤动(AF)患者的有效性,并分析其术后AF复发相关影响因素。方法前瞻性收集2020年5月至2022年2月于天津医科大学第二医院心脏内科行AF冷冻消融术的老年患者165例,术前收集受试者基线资料,平均随访(8.90±5.62)个月,根据随访期间是否出现AF复发分为复发组40例和非复发组125例,对比2组临床资料,采用多因素Cox回归模型分析影响预后的因素。结果复发组阵发性AF比例明显低于非复发组,早期复发比例明显高于非复发组,差异有统计学意义(P<0.05,P<0.01)。多因素Cox回归分析显示,早期复发(HR=10.098,95%CI:3.627~28.111,P=0.000)和右心房上下径(HR=1.130,95%CI:1.025~1.247,P=0.014)为老年患者冷冻球囊消融术后AF复发的独立预测因素。结论冷冻球囊消融术可作为老年AF患者有效的治疗方案,3个月内早期复发和右心房上下径为老年患者冷冻球囊消融术后AF复发的独立危险因素。Objective To evaluate the efficacy of cryoballoon ablation in the treatment of elderly patients with atrial fibrillation(AF),and to analyze the related factors of postoperative AF recurrence.Methods A total of 165 elderly patients undergoing AF cryoablation in our department from May 2020 to February 2022 were prospectively recruited in this study.Their baseline data were collected before operation.All the patients were followed up for an average of 8.90±5.62 months.According to the recurrence of AF during the follow-up period,they were divided into recurrent group(n=40)and non-recurrent group(n=125).The prognostic factors were analyzed by multivariate Cox regression model.Results The recurrent group had significantly lower proportion of paroxysmal AF and lower proportion of early recurrence than the non-recurrent group(P<0.05,P<0.01).Multivariate Cox regression analysis showed that early recurrence(HR=10.098,95%CI:3.627-28.111,P=0.000)and superior-inferior diameter of right atrium(HR=1.130,95%CI:1.025-1.247,P=0.014)were independent predictors of AF recurrence in elderly patients after cryoballoon ablation.Conclusion Cryoablation is an effective option for the elderly AF patients.Early recurrence within 3 months and superior and inferior diameter of right atrium are independent risk factors for recurrence after cryoablation in them.

关 键 词：心房颤动 导管消融术 复发 抗心律失常药 危险因素 

分 类 号：R541.75[医药卫生—心血管疾病]