成人先心病合并典型心房扑动患者导管消融术后新发心房颤动的临床研究

New-onset atrial fibrillation(AF)in patients with adult congenital heart disease accompanied by typical atrial flutter after catheter ablation:a clinical study

目的探讨成人先天性心脏病(先心病)合并典型心房扑动(房扑)患者导管消融术后新发心房颤动(房颤)的发生率和高危因素。方法选取2013年7月至2019年7月于河南省人民医院心血管内科接受典型房扑导管消融的32例成人先心病患者为研究对象,并对消融术后新发房颤的发生情况随访。分析新发房颤的发生率及高危因素。结果平均随访(35.81±16.16)个月后,12例患者(37.5%)出现了新发房颤。新发房颤的中位发生时间为术后22个月。多因素Cox回归分析显示典型房扑导管消融术中诱发房颤与新发房颤独立相关(风险比:6.093;95%CI:1.924~19.294,P=0.002)。结论成人先心病患者行典型房扑导管消融术后有发生新发房颤的风险,房扑消融术中诱发房颤是新发房颤的独立危险因素。

Objective To investigate the incidence rate and risk factors of new-onset atrial fibrillation(AF)in patients with adult congenital heart disease(ACHD)accompanied by typical atrial flutter(AFL)after catheter ablation.Methods The patients with ACHD accompanied by typical AFL undergone catheter ablation(n=32)were chosen from Department of Cardiovascular Medicine of Henan Provincial People’s Hospital from July 2013 to July 2019,and the incidence of new-onset AF after catheter ablation was followed up.The incidence rate and high-risk factors of new-onset AF were analyzed.Results There were 12(37.5%)patients with new-onset AF after followed up for average(35.81±16.16)months.The median time of new-onset AF incidence was 22 months after catheter ablation.The results of multi-factor Cox regression analysis showed that AF induced during catheter ablation for typical AFL was independently correlated to new-onset AF(HR=6.093,95%CI:1.924~19.294,P=0.002).Conclusion ACHD patients have risk of new-onset AF after catheter ablation for typical AFL,and AF induced during catheter ablation is an independent risk factor of new-onset AF.