典型房扑射频消融术后部分患者发生房颤的危险因素分析

Analysis of high risk factors for atrial fibrillation in patients after radiofrequency ablation of typical atrial flutter

目的分析典型房扑射频消融术后部分患者发生房颤的危险因素。方法选择2015年2月至2018年2月六安市人民医院体表心电图提示典型房扑、电生理检查均证实为三尖瓣环峡部依赖性房扑并成功给予三尖瓣峡部线性消融(CTIA)手术的患者68例,随访6~34个月。根据术后随访是否发生房颤分为两组,其中发生房颤组23例,未发生房颤组45例,比较两组患者年龄、基础疾病、P波宽度及离散度、左房内径(LAD)、左室舒张末内径(LVEDD)、左室射血分数(LVEF)及口服药物的差异。结果两组患者的P波宽度、P波离散度、LAD、LVEDD、LVEF进行比较,差异有统计学意义(P<0.05)。logistic回归分析显示,LAD、P波宽度及离散度是典型房扑射频消融术后发生房颤的独立危险因素。结论LAD、P波宽度及离散度是预测典型房扑射频消融术后发生房颤的重要指标。

Objective To analyze the high risk factors of atrial fibrillation(AF)in some patients after radiofrequency ablation of typical atrial flutter.Methods Sixty-eight patients with tricuspid annular isthmus dependent atrial flutter confirmed by ECG and electrophysiological examination from February 2015 to February 2018 were selected and successfully treated with tricuspid isthmus linear ablation(CTIA).The follow-up period was 6~34 months.According to the occurrence of AF after operation,the patients were divided into AF group(23 patients)and non-AF group(45 patients).The age,basic disease,P wave width and dispersion,left atrial diameter(LAD),left ventricular end-diastolic diameter of left ventricle(LVEDD),left ventricular ejection fraction(LVEF)and oral drugs were compared between two groups.Results There was statistical significance in the difference in P-wave width,P-wave dispersion,LAD,LVEDD and LVEF of two groups(P<0.05).Logistic regression analysis showed that LAD,P wave width and dispersion were independent risk factors for AF after radiofrequency ablation of typical atrial flutter.Conclusion LAD,P wave width and dispersion are important indicators for predicting AF after radiofrequency ablation of typical atrial flutter.