心房颤动患者行肺静脉大环隔离消融术后复发的影响因素分析
发布时间：2019-04-03 09:54
【摘要】：目的探讨心房颤动(简称房颤)患者行肺静脉大环隔离导管射频消融术后复发的影响因素。方法选择房颤患者110例,包括阵发性房颤86例、持续性房颤24例。均采用肺静脉大环隔离行射频消融治疗,术中线性消融双侧环肺静脉。术后口服抗心律失常药物胺碘酮及抗凝药物华法林(或利伐沙班)3个月。术后3、6、9、12个月时随访心电图与24 h动态心电图,以手术3个月后发生的持续大于30 s的房性心律失常为房颤复发标准,评价术后的房颤复发情况。采用Logistic回归法分析术后复发的影响因素分析,采用COX回归分析法评价术前不同左心房前后径对房颤患者术后复发的影响。结果术后1年阵发性房颤的复发率为30.2%,持续性房颤的复发率为50.0%。左心房前后径是房颤患者导管消融术后复发的独立预测因子(HR=2.33,95%CI为1.41~4.61)。左心房前后径40 mm是导致房颤患者术后复发的危险因素。结论肺静脉大环隔离术治疗房颤患者具有一定的术后复发率,术前左心房前后径40 mm是导致术后房颤复发的危险因素。
[Abstract]:Objective to investigate the risk factors of recurrence in patients with atrial fibrillation (AF) after radiofrequency catheter ablation. Methods 110 patients with AF, including 86 paroxysmal AF and 24 persistent AF, were selected. All patients were treated with radiofrequency ablation (RFCA), and bilateral circumferential pulmonary veins were ablated linearly during the operation. After operation, the antiarrhythmic drug amiodarone and anticoagulant warfarin (or rivastatin) were given orally for 3 months. After 3, 6, 9, 12 months follow-up electrocardiogram (ECG) and 24-hour dynamic electrocardiogram (24-h) were followed up. The recurrence of atrial fibrillation was evaluated according to the occurrence of atrial arrhythmias more than 30 s after operation. Logistic regression was used to analyze the influencing factors of postoperative recurrence. COX regression analysis was used to evaluate the effect of different anterior and posterior diameters of left atrium before operation on postoperative recurrence in patients with AF. Results the recurrence rate of paroxysmal AF and persistent AF was 30.2% and 50.0% respectively. The anteroposterior diameter of left atrium was an independent predictor of recurrence after catheter ablation in patients with AF (HR=2.33,95%CI = 1.41? 4.61). Left atrial anteroposterior diameter 40 mm is a risk factor for postoperative recurrence of AF. Conclusion the pulmonary vein great ring isolation has a certain postoperative recurrence rate in patients with atrial fibrillation. The anterior and posterior diameter of left atrium 40 mm before operation is a risk factor for recurrence of atrial fibrillation after operation. [WT5 "HZ] conclusion [WT5" BZ]
【作者单位】： 新疆维吾尔自治区人民医院;
【分类号】：R541.75
，
本文编号：2453115
[Abstract]:Objective to investigate the risk factors of recurrence in patients with atrial fibrillation (AF) after radiofrequency catheter ablation. Methods 110 patients with AF, including 86 paroxysmal AF and 24 persistent AF, were selected. All patients were treated with radiofrequency ablation (RFCA), and bilateral circumferential pulmonary veins were ablated linearly during the operation. After operation, the antiarrhythmic drug amiodarone and anticoagulant warfarin (or rivastatin) were given orally for 3 months. After 3, 6, 9, 12 months follow-up electrocardiogram (ECG) and 24-hour dynamic electrocardiogram (24-h) were followed up. The recurrence of atrial fibrillation was evaluated according to the occurrence of atrial arrhythmias more than 30 s after operation. Logistic regression was used to analyze the influencing factors of postoperative recurrence. COX regression analysis was used to evaluate the effect of different anterior and posterior diameters of left atrium before operation on postoperative recurrence in patients with AF. Results the recurrence rate of paroxysmal AF and persistent AF was 30.2% and 50.0% respectively. The anteroposterior diameter of left atrium was an independent predictor of recurrence after catheter ablation in patients with AF (HR=2.33,95%CI = 1.41? 4.61). Left atrial anteroposterior diameter 40 mm is a risk factor for postoperative recurrence of AF. Conclusion the pulmonary vein great ring isolation has a certain postoperative recurrence rate in patients with atrial fibrillation. The anterior and posterior diameter of left atrium 40 mm before operation is a risk factor for recurrence of atrial fibrillation after operation. [WT5 "HZ] conclusion [WT5" BZ]
【作者单位】： 新疆维吾尔自治区人民医院;
【分类号】：R541.75
，
本文编号：2453115
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