房颤首次射频消融术后复发的相关危险因素探讨

Risk factors for recurrence of atrial fibrillation after first radiofrequency ablation

目的:分析心房颤动(房颤,Atrial fibrillation,AF)首次经导管射频消融(Radiofrequency catheter ablation,RFCA)术后复发患者的临床特点,探讨影响房颤患者术后复发的危险因素。方法:回顾分析268例行经导管射频消融治疗的房颤患者的临床病历资料,根据术后随访情况将上述患者分为射频消融治疗的复发组和未复发组,探讨影响房颤患者术后复发的危险因素。结果:本研究根据排除标准共纳入房颤患者212例,随访时间为消融手术之日起1年,至此有54例(25.5%)患者房颤复发,余158例(74.5%)患者未复发。复发组患者相对于未复发组持续性房颤比例更大,房颤病程更长,左房前后径更大,白细胞、中性粒/淋巴细胞比值、球蛋白(Globulin)、尿酸(Uric Acid,UA)、同型半胱氨酸(Homocysteine,HCY)数值更大,而未复发组射血分数(Ejection fraction EF)更高,差异有统计学意义(P<0.05)。结论:COX多因素回归分析显示,房颤病程、房颤类型是房颤患者射频消融术后复发的独立危险因素。

Objective To analyze the clinical features of patients with recurrence after radiofrequency catheter ablation (RFCA) with atrial fibrillation (AF),and to explore the risk factors for postoperative recurrence in patients with atrial fibrillation. Method The clinical records of 268 patients with atrial fibrillation who underwent transcatheter radiofrequency ablation were retrospectively analyzed.The patients were divided according to postoperative follow-up.The recurrence and non-recurrence groups of radiofrequency ablation were used to investigate the risk factors for postoperative recurrence in patients with atrial fibrillation. Results A total of 212 patients with atrial fibrillation were enrolled according to the exclusion criteria.The follow-up period was 1 year from the date of ablation.Up to now,54 patients (25.5%) had recurrence of atrial fibrillation,and the remaining 158 patients (74.5%) had no recurrence.Patients in the relapse group had a greater proportion of persistent atrial fibrillation than the non-recurrent group,a longer duration of atrial fibrillation,greater left anteroposterior diameter,white blood cell,neutrophil/lymphocyte ratio,globulin (Globulin),uric acid (Uric Acid,UA),homocysteine (HCY) values were larger,and in the non-recurrent group,ejection fraction EF was higher (P<0.05). Conclusion Cox multivariate regression analysis showed that the duration of atrial fibrillation and atrial fibrillation are independent risk factors for recurrence after radiofrequency ablation in patients with atrial fibrillation.