肥胖对于持续性心房颤动导管消融治疗结果的影响

Effect of obesity on the outcome of catheter ablation for persistent atrial fibrillation

目的:探讨肥胖对于持续性心房颤动(房颤)导管消融治疗的有效性及安全性影响。方法:选择在本中心接受导管消融治疗并能按计划完成随访的持续性房颤患者为研究对象。根据体质指数(BMI)将患者分为正常体重(<24.0kg/m2)、超重(24.0～27.9kg/m2)及肥胖(≥28.0kg/m2)3组。在接受初次导管消融术后,所有患者由固定医生进行随访。通过单变量及多变量回归分析评估肥胖与术后复发间的相关性。结果:342例患者纳入本研究。随访时间为(12.5±9.7)个月,在接受1次消融术后,137例在随访期复发,故本组1次消融成功率为59.9%。根据BMI,分别有109、167、66例属于体重正常、超重、肥胖组。3组间术后复发率差异无统计学意义(P=0.87)。多变量Cox回归分析结果显示左房容积(OR,1.006;95%CI,1.00～1.01;P=0.04)及房颤持续时间(OR,1.06;95%CI,1.03～1.08;P<0.001)是术后复发的独立危险因素。结论:肥胖及超重对于持续性房颤导管消融结果无明显影响。仅有房颤持续时间及左房容积可预测术后复发。

Objective：To explore the influence of obesity on the effectivity and safety of catheter ablation for persistent atrial fibrillation （Af）.Method：Patients with persistent Af who had undergone catheter ablation and completed follow-up as planned were involved in this study.According to the body mass index （BMI）,patients were grouped as normal weight （24.0 kg/m2）,overweight （24.0-27.9 kg/m2）,and obesity （≥28.0 kg/m2）.All patients underwent follow-up by a referring physician after a single ablation procedure.Result：There were 342 patients involved in this study in all.During a mean follow-up of 12.5 ± 9.7 months,recurrence were demonstrated in 137 patients after a single ablation procedure.The success rate of ablation was 59.9%; 109,167 and 66patients belonged to normal weight,overweight and obesity group,respectively.With respect to the recurrence rate,there was no significant difference found among the BMI groups （P=0.87）.On multivariate Cox regression analysis,the left atrium volume （OR,1.006; 95% CI,1.00 to 1.01; P=0.04） and persisting duration of AF （OR,1.06; 95% CI,1.03 to 1.08; P0.001） were independently significant predictors for recurrence.Conclusion：Obesity and overweight had no significant effect on the outcome of ablation in persistent Af patients.The persisting duration of Af and the left atrial dimension could predict the recurrence.