CHA_(2)DS_(2)-VASC评分与阵发性心房颤动射频消融术后复发的关联分析  

Correlation between CHA_(2)DS_(2)-VASC score and recurrence of paroxysmal atrial fibrillation after radiofrequency ablation

作　　者：杜瑞娟[1] 魏庆民[1] 樊延明[1] 王世杰[1] 张艳龙 葛国庆[1] Du Ruijuan;Wei Qingmin;Fan Yanming;Wang Shijie;Zhang Yanlong;Ge Guoqing(Department of Cardiology,Xingtai People′s Hospital,Xingtai 054001,China)

机构地区：[1]邢台市人民医院心内科,邢台054001

出　　处：《中华全科医师杂志》2024年第1期52-56,共5页Chinese Journal of General Practitioners

基　　金：邢台市科技重点研发计划(2021ZC139)。

摘　　要：目的探讨CHA_(2)DS_(2)-VASC评分与阵发性心房颤动(房颤)患者射频消融术后房颤复发的关联。方法该研究为回顾性队列研究。连续纳入2017年1月1日至2021年1月1日于邢台市人民医院住院的因阵发性房颤拟行射频消融术的患者,根据术前CHA_(2)DS_(2)-VASC评分将患者分为高分组(≥3分)和低分组(<3分)。收集入选患者的基线临床资料。入选患者均行环肺静脉隔离,术前合并心房扑动者同时进行三尖瓣峡部隔离。于术后3、6个月和1年对患者进行动态心电图检查,评估有无房颤复发。采用单因素和多因素Cox回归模型分析阵发性房颤患者射频消融术后房颤复发的危险因素。结果共纳入患者150例,年龄(64.0±3.6)岁,男性90例(60%),其中低分组60例、高分组90例。两组患者间男性占比,年龄,合并高血压、糖尿病、慢性心力衰竭、既往卒中/短暂性脑缺血发作者占比,合并心房扑动者占比,服用抗心律失常药物、抗凝药物者占比,差异均无统计学意义(均P>0.05)。高分组患者房颤最长持续时间为(26.0±6.1)h,长于低分组的(10.0±2.1)h(P<0.05)。随访期间高分组房颤复发者占比高于低分组[15例(16.7%)比5例(8.3%),P=0.040]。单因素Cox回归分析结果显示房颤最长持续时间>24 h、CHA_(2)DS_(2)-VASC评分≥3分是阵发性房颤患者射频消融术后房颤复发的危险因素(均P<0.05)。多因素Cox回归分析结果显示CHA_(2)DS_(2)-VASC评分≥3分是阵发性房颤患者射频消融术后房颤复发的独立危险因素(HR=3.84,95%CI:1.87~7.89,P=0.02)。结论CHA_(2)DS_(2)-VASC评分≥3分是阵发性房颤患者射频消融术后房颤复发的独立危险因素。Objective To investigate the correlation between CHA_(2)DS_(2)-VASC score and the recurrence risk of paroxysmal atrial fibrillation after radiofrequency ablation.Methods It was a retrospective cohort study.A total of 150 patients who underwent radiofrequency ablation for paroxysmal atrial fibrillation in Xingtai People′s Hospital from January 2017 to January 2021 were consecutively included in the study.According to the preoperative CHA_(2)DS_(2)-VASC score,patients were divided into high score group(≥3 points,n=90)and low score group(<3 points,n=60).Baseline clinical data was collected.All patients underwent circumferential pulmonary vein isolation,and those with atrial flutter before ablation also underwent tricuspid isthmus isolation.Holter and electrocardiogram examinations were performed at 3,6 months and 1 year after ablation to evaluate whether there was recurrence of atrial fibrillation.Univariate and multivariate Cox regression was used to analyze the risk factors for recurrence of atrial fibrillation after radiofrequency ablation.Results Among 150 patients 90 were males and 60 were females with a mean age of(64.0±3.6)years.There were no significant differences in age,sex,and proportion of hypertension,diabetes,chronic heart failure and stroke or transient ischemic attack(TIA),medication of antiarrhythmic and anticoagulant drugs between the two groups(all P>0.05).The longest duration of atrial fibrillation in the high score group was significantly longer than that in the low score group(26.0±6.1)hours vs.(10.0±2.1)hours,P<0.05).There were no patients with cardiac tamponade,atrial esophageal fistula and severe vascular puncture complications in the two groups.During the follow-up period,the recurrence rate in the high score group was significantly higher than that in the low score group(16.7%(15/90)vs.8.3%(5/60),P<0.05).Multivariate Cox regression analysis showed that CHA_(2)DS_(2)-VASC score≥3 was an independent risk factor for atrial fibrillation recurrence in patients with paroxysmal atrial fi

关 键 词：心房颤动 射频消融术 复发 CHA_(2)DS_(2)-VASC评分 

分 类 号：R541.75[医药卫生—心血管疾病]