导管射频消融术治疗非缺血性心肌病室性心动过速患者的长期疗效分析:单中心经验  

Long-Term Outcomes of Radiofrequency Ablation for Patients with Non-Ischemic Cardiomyopathy and Ventricular Tachycardia:A Single-Center Experience

作　　者：廖江延 张佳媛 刘方舟[1] 廖洪涛[1] 方咸宏[1] 邓海[1] 薛玉梅[1] 詹贤章[1] LIAO Jiangyan;ZHANG Jiayuan;LIU Fangzhou;LIAO Hongtao;FANG Xianhong;DENG Hai;XUE Yumei;ZHAN Xianzhang(Department of Cardiology,Guangdong Cardiovascular Institute,Guangdong Provincial People′s Hospital(Guangdong Academy of Medical Sciences),Southern Medical University,Guangzhou 510080,China)

机构地区：[1]广东省心血管病研究所南方医科大学附属广东省人民医院(广东省医学科学院)心内科,广州510080

出　　处：《岭南心血管病杂志》2024年第6期592-597,共6页South China Journal of Cardiovascular Diseases

摘　　要：目的探索非缺血性心肌病(non-ischemic cardiomyopathy,NICM)合并室性心动过速(ventricular tachycardia,VT)患者行导管射频消融的长期疗效,分析影响疗效的因素。方法本研究回顾性分析了2008年1月至2022年12月于广东省人民医院住院确诊为NICM-VT并行VT导管射频消融治疗的患者的临床资料。收集入选患者的临床基线数据、电生理资料及随访结果,采用单因素分析和多因素分析的方法分析影响长期疗效的因素。结果纳入106例患者(男79例,女27例),年龄为(45.3±15.9)岁。经过33.2个月(中位随访时间)随访,39例患者VT复发,复发率为36.8%,8例死亡,病死率为7.5%。多因素回归分析显示年龄和VT种类≥3种是VT复发的独立危险因素(HR=1.040,95%CI:1.011~1.067,P=0.006;HR=2.623,95%CI:1.250~5.479,P=0.011),未提示消融途径是VT复发的独立危险因素。心力衰竭再入院是全因死亡的独立危险因素(HR=11.236,95%CI:1.728~73.074,P=0.011)。结论在经导管射频消融的NICM-VT患者中,术中VT种类≥3种、年龄是VT复发的独立危险因素,心力衰竭再入院是全因死亡的独立危险因素。Objectives To explore the long-term efficacy of radiofrequency catheter ablation in patients with nonischemic cardiomyopathy(NICM)complicated with ventricular tachycardia(VT),and analyze the factors that affect the efficacy of radiofrequency catheter ablation.Methods This study retrospectively analyzed the clinical data of patients admitted to Guangdong Provincial People′s Hospital from January 2008 to December 2022 who were diagnosed with NICMVT combined with VT and underwent catheter radiofrequency ablation.The clinical baseline data,electrophysiological data and follow-up results of the enrolled patients were collected,and the factors affecting the long-term curative effect were analyzed by univariate analysis and multi-factor analysis.Results A total of 106 patients(79 males and 27 females)with an average age of(45.3±15.9)years were included.After a follow-up of 33.2 months(median follow-up time),39 patients had VT relapse,thus the recurrence rate was 36.8%;8 patients died,and the mortality rate was 7.5%.Multivariate regression analysis showed that age and VT type≥3 were independent risk factors for VT recurrence(HR=1.040,95%CI:1.011-1.067,P=0.006;HR=2.623,95%CI:1.250-5.479,P=0.011),but did not suggest that ablation pathway was an independent risk factor for VT recurrence.Heart failure readmission was an independent risk factor for all-cause death(HR=11.236,95%CI:1.728-73.074,P=0.011).Conclusions In NICM-VT patients undergoing radiofrequency catheter ablation,age and≥3 types of VT during operation are independent risk factors for VT recurrence,and heart failure readmission is an independent risk factor for all-cause death.

关 键 词：非缺血性心肌病 室性心动过速 射频消融 

分 类 号：R542.2[医药卫生—心血管疾病] R541.7[医药卫生—内科学]