睡眠呼吸暂停低通气综合征对心房颤动经导管射频消融术预后的影响分析

Effect of Sleep Apnea Hypopnea Syndrome on the Prognosis of Atrial Fibrillation after Radiofrequency Catheter Ablation

目的:探讨睡眠呼吸暂停低通气综合征(SAHS)是否影响心房颤动(房颤)经导管射频消融术的预后。方法:选取2019年1月至2020年12月在中国医学科学院阜外医院接受多导睡眠监测并接受经导管射频消融术的房颤患者498例,SAHS组252例,非SAHS组246例。记录两组患者的基本临床资料、房颤类型及睡眠呼吸异常类型,随访术后房颤复发情况。结果:24个月的中位随访期内,术后总房颤复发率为33.0%。SAHS组和非SAHS组患者术后房颤复发率分别为30.1%和37.4%,差异无统计学意义(P>0.05)。SAHS组和非SAHS组中,阵发性房颤和持续性房颤患者术后房颤复发率差异均无统计学意义(P均>0.05);SAHS组中低通气型患者、阻塞性睡眠呼吸暂停患者与非SAHS组患者的房颤复发率差异均无统计学意义(P均>0.05);SAHS组和非SAHS组中,房颤复发患者和房颤未复发患者的左心房前后径、体重指数(BMI)差异均无统计学意义(P均>0.05)。结论:SAHS不影响经导管射频消融术后房颤复发率。

Objectives:To investigate the impact of sleep apnea hypopnea syndrome(SAHS)on the prognosis of atrial fibrillation(AF)patients after radiofrequency catheter ablation.Methods:A total of 498 AF patients who underwent polysomnography and radiofrequency catheter ablation in Fuwai Hospital,Chinese Academy of Medical Sciences from January 2019 to December 2020 were selected and divided into the SAHS group(n=252)and the non-SAHS group(n=246).The basic information of the 498 patients were recorded.The type of AF and the type of sleep apnea were used as stratification factors for comparison,and the recurrence of postoperative AF was recorded.Results:The total recurrence rate of AF was 33.0%during the median follow-up of 24 months.The recurrence rate of AF in SAHS group and non-SAHS group was similar(30.1%vs.37.4%,P>0.05).There was no significant difference in the recurrence rate between the SAHS group and the non-SAHS group with paroxysmal or persistent AF(all P>0.05).There was no significant difference in the recurrence rate of AF between the SAHS group with moderate/low ventilation syndrome or obstructive sleep apnea and the non-SAHS group(all P>0.05).In SAHS group and non-SAHS group,there was no significant difference in left atrial anterior-posterior diameter and body mass index between recurrent and non-recurrent patients(all P>0.05).Conclusions:Preoperative SAHS does not affect the recurrence rate of AF after radiofrequency ablation.