青年心房颤动患者经二代冷冻球囊消融疗效及早期复发因素分析  

Efficacy and recurrence factors of the second-generation cryoballoon ablation in young adults with atrial fibrillation

作　　者：蔡文芝 孙鸣宇[1] 王祖禄 梁明 金志清 Cai Wenzhi;Sun Mingyu;Wang Zulu;Liang Ming;Jin Zhiqing(Department of Cardiology,General Hospital of Northern Theater Command,State Key Laboratory of Frigid Zone Cardiovascular Diseases(SKLFZCD),Shenyang 110016,China;Department of Geratology,Liaocheng People's Hospital,Liaocheng 252000,China)

机构地区：[1]北部战区总医院心血管内科、寒地心血管病全国重点实验室,沈阳110016 [2]聊城市人民医院老年医学科,聊城252000

出　　处：《中华心律失常学杂志》2024年第4期316-321,共6页Chinese Journal of Cardiac Arrhythmias

基　　金：辽宁省应用基础研究计划(2022JH2/101500015)。

摘　　要：目的分析青年非瓣膜性心房颤动(房颤)患者导管消融疗效及复发因素。方法本研究为横断面研究。回顾性连续入选2019年1月至2020年12月入住北部战区总医院并接受二代冷冻球囊消融治疗的18~44岁诊断为房颤的青年患者(青年组),并在同期≥45岁房颤患者中按1∶2倾向评分匹配对照组,搜集患者临床资料,术后每3个月及第12个月对患者进行电话或门诊随访。结果共入选青年组患者48例,年龄(39.92±5.78)岁,对照组96例,年龄(59.27±7.54)岁,两组患者年龄、CHA_(2)DS_(2)-VAS_(C)评分差异具有统计学意义(P<0.001、P=0.023)。经1年随访共40例(27.78%,40/144)患者早期复发,其中青年组14例(29.17%,14/48),对照组26例(27.08%,26/96),Kaplan-Meier生存曲线分析显示两组间术后1年生存率差异无统计学意义(Log-Rank:P=0.865)。青年组患者空白期发作、空腹血糖升高是其二代冷冻球囊消融术后早期复发的危险因素,空腹血糖每增加1 mmol/L,房颤患者术后早期复发概率增加78.9%(HR=1.789,95%CI 1.081~2.962,P=0.024)。总人群及对照组患者,空白期发作、持续性房颤是其二代冷冻球囊消融术后早期复发的危险因素。结论青年房颤患者尽早开展导管消融等干预措施进行节律控制,并严格控制血糖,可降低房颤术后复发风险。Objective To analyze the efficacy and recurrence factors of the second-generation cryoballoon ablation in young patients with non-valvular atrial fibrillation(AF).Methods A cross-sectional retrospective analysis was performed on young patients aged 18-44 years who were admitted to General Hospital of Northern Theater Command from January 2019 to December 2020 and received second-generation cryoballoon ablation(young group).The patients with atrial fibrillation≥45 years old in the same period were matched with the control group according to the 1∶2 propensity score.The general information and laboratory test were analyzed retrospectively.The patients were followed up by telephone or outpatient every 3 months and 12 months after operation.Results A total of 48 patients in the young group with an age of(39.92±5.78)years,and 96 patients in the control group with an age of(59.27±7.54)years were enrolled in the study.There were significant differences in age and CHA_(2)DS_(2)-VAS_(c)score between the two groups(P<0.001,P=0.023).After one-year follow-up,a total of 40 patients(27.78%,40/144)had early recurrence,including 14 patients in the young group(29.17%,14/48)and 26 patients in the control group(27.08%,26/96).Kaplan-Meier survival analysis showed that there was no significant difference in 1-year survival rate between the two groups(Log-Rank:P=0.865).Blanking recurrence and elevated fasting blood glucose in young patients were the risk factors of early recurrence after second-generation cryoballoon ablation.For every 1 mmol/L increase in fasting blood glucose,the probability of early recurrence in patients with AF increased by 78.9%(HR=1.789,95%CI 1.081-2.962,P=0.024).In the total population and the control group,the blanking recurrence and persistent AF were the risk factors of early recurrence after second-generation cryoballoon ablation.Conclusion Early intervention measures such as catheter ablation should be taken to control the rhythm and strictly control blood sugar in young patients with AF,in order to

关 键 词：心房颤动 青年 二代冷冻球囊 复发因素 

分 类 号：R541.75[医药卫生—心血管疾病]