巨细胞病毒感染对射频消融术后心房颤动复发的影响

Influence of cytomegalovirus infection on recurrence of atrial fibrillation after radiofrequency catheter ablation

目的：探讨巨细胞病毒（CMV）感染对射频消融术后心房颤动（房颤）复发的预测价值。方法 ：严格筛选103例首次接受射频消融治疗的孤立性房颤患者,随访观察患者射频消融术后房颤复发情况。所有患者于射频消融术前检测血清CMV免疫球蛋白（Ig）G抗体水平。结果：平均随访（12.8±7.0）个月,29例患者房颤复发。与未复发者相比,复发者年龄较小[（54.03±9.84）比（59.1±11.0）岁,P=0.034]、血清CMV Ig G抗体水平较高[（260.24±29.10）比（241.34±33.49）mg/L,P=0.01]。Cox多元回归分析显示,血清CMV Ig G抗体水平是消融术后房颤复发的独立危险因素[风险比（HR）=1.013,95%可信区间（CI）：1.0~1.025,P=0.029]。血清CMV Ig G抗体水平截断值为237.61μg/m L时预测房颤复发的灵敏度为83%,特异度为49%。结论：CMV感染与射频消融术后房颤复发相关,房颤患者的血清CMV Ig G抗体水平预测消融术后房颤复发具有良好的敏感性。

Objective To analyze the influence of cytomegalovirus（CMV） infection on recurrence of atrial fibrillation（AF） after successful radiofrequency catheter ablation（RFCA）. Methods One hundred and three lone AF patients initially undergoing RFCA were enrolled and evaluated. Level of immunoglobulin G（Ig G） antibody against CMV was monitored before RFCA. Results During a mean follow-up period of（12.8 ±7.0） months, 29 patients had recurrence of AF. AF patients with recurrence were younger [（54.03±9.84） vs（59.1±11.0） years, P=0.034], and had a significantly higher level of anti-CMV Ig G than patients without AF recurrence [（260.24 ±29.10） vs（241.34 ±33.49） mg/L, P =0.01]. Cox multivariate regression analysis revealed that anti-CMV Ig G level was an independent risk factor of AF recurrence[hazard ratio（HR）=1.013, 95% confidence interval（CI） 1.0-1.025, P=0.029]. Cut-off point of 237.61 μg/m L for antiCMV Ig G had a sensitivity of 83% and specificity of 49% in predicting AF recurrence. Conclusions CMV infection is associated with the recurrence of AF after radiofrequency catheter ablation. Level of anti-CMV Ig G is sensitive for the prediction of post-RFCA AF recurrence.