预防心房纤维化对心房颤动患者射频导管消融术后复发的影响

Prevention of Atrial Fibrosis Affects Atrial Fibrillation Recurrence after Radiofrequency Ablation

目的探讨心房纤维化的药物预防对心房颤动(房颤)患者射频导管消融术后复发的影响。方法选取2017年6月-2018年3月于武汉大学人民医院行首次射频导管消融术的非瓣膜性房颤患者112例。收集患者临床资料并进行随访,记录患者术后预防心房纤维化的药物类型和剂量,根据随访1年的结果将患者分为术后复发组(n=19)和未复发组(n=83)。比较两组患者一般资料、实验室检查和服用药物的差异,采用SPSS 22数据分析判断心房纤维化的药物预防对房颤患者射频导管消融术后复发的影响。结果房颤患者消融术后复发组与未复发组的性别、年龄、房颤类型、高血压、糖尿病、冠心病等疾病、hs-CRP、e GFR、SCr、UA的差异无统计学意义(P> 0. 05),复发组的房颤初发年龄、房颤病史及NT-pro BNP水平明显高于未复发组(P <0. 05)。药物预防心房纤维化可减少房颤患者射频导管消融术后的1年复发率(P=0. 015),较长的房颤病史是房颤术后复发的独立危险因素。结论房颤患者射频导管消融术后复发率与房颤初发年龄、房颤病史和NT-proBNP水平相关,药物预防心房纤维化可降低房颤患者射频导管消融术后的1年复发率。

Objective To investigate the effect of preventing atrial fibrosis on atrial fibrilation recurrence after radiofrequency catheter ablation( RFCA) in patients with nonvalvular atrial fibrillation( NVAF). Methods A total of 112 patients with NVAF after first RFCA at Renmin Hospital of Wuhan University from June 2017 to March 2018 were enrolled and followed up for 1 year. After one-year follow-up,the patients can be divided into recurrent group( n = 19) and non-recurrent group( n = 83). Baseline information,laboratory examination results and medication-taking information were compared between the two groups,and the effect of anti-fibrosis medication on recurrence of atrial fibrillation( AF) were analyzed. Results Initial age of AF,history of AF,and NT-proBNP level in recurrent group were significantly higher than non-recurrent group( P < 0. 05). Meanwhile,the age,sex,AF type,hypertension,diabetes mellitus,hs-CRP,e GFR,SCr and UA showed no significant difference. Longer history of AF was an independent risk factor for recurrence of AF,and drugs to prevent atrial fibrosis could reduce the recurrence rate. Conclusion The recurrence rate of AF after RFCA is correlated with initial age of AF,history of AF and NT-proBNP level. Drugs to prevent atrial fibrosis can reduce the recurrence rate of AF after RFCA.