心房颤动患者导管射频消融术后复发风险预测模型的系统评价  

Systematic review of recurrence risk prediction models in patients with atrial fibrillation after RFCA

作　　者：高晓 孙琳琳 王一帆 王文昭 迟嘉婧 GAO Xiao;SUN Linin;WAGN Yifan;WAGN Wenzhao;CHI Jiajing(Department of Interventional Diagnosis and Treatment,Shandong Provincial Hospital Affiliated to Shandong First Medical University,Jinan China)

机构地区：[1]山东第一医科大学附属省立医院介入诊疗科,山东济南250021 [2]山东第一医科大学附属省立医院保健耳鼻喉科,山东济南250021 [3]山东大学齐鲁医院院外急救科,山东济南250012

出　　处：《山东医药》2025年第1期114-118,共5页Shandong Medical Journal

摘　　要：目的对心房颤动(AF)患者导管射频消融(RFCA)术后复发的风险预测模型进行系统评价,为临床治疗AF提供依据。方法检索中国知网数据库、万方数据库、维普数据库、中国生物医学文献数据库以及PubMed、CINAHL、Web of Science、Embase、Cochrane Library数据库中“AF患者RFCA术后复发的风险预测模型”相关文献,检索年限为建库至2024年5月11日,提取文献数据,用预测模型偏倚风险评估工具评价所纳入模型的偏倚风险和适用性。结果最终纳入文献19篇,发表于2021—2024年,全部来源于中国。11篇文献为模型建立,8篇文献为模型建立与验证。最终纳入19个模型,样本总量为136~6127例,复发率为8.70%~48.57%。19篇文献报告了模型预测AF患者RFCA术后复发的曲线下面积,为0.723~0.938。模型重复报告的前6位预测变量为左心房内径、年龄、AF类型、AF病程、性别和BMI。1篇文献偏倚风险评估为“不清楚”,其余18篇文献均为“高偏倚风险”;5篇文献适用性“不清楚”,其余14篇文献适用性风险较低。结论AF患者RFCA术后复发风险预测模型研究开展较晚,建模方式多数基于Logistic回归分析构建列线图模型,纳入的19个模型预测效能较高,预测因子可从临床资料、影像学资料、电生理检查中筛选,模型整体偏倚风险较高。Objective To systematicly evaluate the risk prediction models for recurrence after radiofrequency catheter ablation(RFCA)in patients with atrial fibrillation and to provide a basis for the clinical treatment of AF.Methods We retrieved the relevant literature on“Risk prediction models for recurrence in AF patients after RFCA”from the CNKI,CSPD,CCD,CBM,PubMed,CINAHL,Web of Science,Embase,and Cochrane Library databases.The search period was from the establishment of the database to May 11,2024.We extracted the literature data and used predictive model bias risk assessment tools to evaluate the bias risk and applicability of the included models.Results Nineteen articles were included,which were published between 2021 and 2024,and all originated from China.Eleven articles were on model establishment,and 8 articles were on model establishment and validation.Totally 19 models were included,with a total sample size of 136-6,127 cases and a recurrence rate of 8.70%-48.57%.Thirteen articles constructed models using Logistic regression analysis,3 articles constructed models using Cox regression,and 1 article constructed models using Lasso regression algorithm and random forest algorithm.Nineteen literature reported the area under the curve,ranging from 0.723 to 0.938.Left atrial diameter,age,type of atrial fibrillation,duration of atrial fibrillation,sex,and BMI were the top 6 predictors of repeated reporting of the models.One article presented as“unclear”in the risk of bias assessment while the remaining 18 articles were“high risk of bias”.The applicability of 5 articles was“unclear”,while the applicability risk of the remaining 14 articles is relatively low.Conclusions The research on recurrence risk prediction models for AF patients after RFCA started relatively late,and most modeling methods were based on Logistic regression analysis to construct nomogram models.The 19 included models had a relatively high area under the curve,and the predictive factors could be screened from clinical data,imaging data,a

关 键 词：心房颤动 导管射频消融术 复发 预测模型 系统评价 

分 类 号：R541.7[医药卫生—心血管疾病]