频发室性早搏与心脏瓣膜手术同期迷宫手术后心房颤动复发关系研究

Relationship between frequent ventricular premature beat and recurrence of atrial fibrillation after cardiac valve surgery with concurrent cox-maze ablation

目的:探讨频发室性早搏(VPB)与心脏瓣膜手术同期射频消融迷宫手术(CMA)后心房颤动(AF)复发的关系。方法:收集因瓣膜疾病合并AF行心脏瓣膜手术同期射频消融迷宫手术的患者115例进行单中心、回顾性、病例对照研究,按照AF是否复发进行分组,复发AF患者23例,未复发患者92例。收集患者一般临床资料和相关实验室检查并评估术前室性早搏负荷(室性早搏数量>10000个/24 h为频发室性早搏)。采用单因素和多因素Cox比例风险回归模型对合并瓣膜疾病的AF患者在接受心脏瓣膜手术及同期射频消融迷宫手术后AF复发的危险因素进行分析。结果:与未复发组比较,复发组室性早搏负荷较高(P<0.05)。多因素Cox回归分析结果显示,频发室性早搏和糖尿病是进行心脏瓣膜手术并同期接受射频消融迷宫手术的患者AF复发的独立危险因素(均P<0.05)。结论:频发室性早搏是心脏瓣膜手术同期射频消融迷宫手术后心房颤动复发的危险因素。

Objective:To investigate the relationship between ventricular premature beat(VPB)and recurrence of atrial fibrillation(AF)after cardiac valve surgery with concurrent cox-maze ablation(CMA).Methods:A single-center,retrospective,case-control study was conducted involving 115 patients who underwent valvular surgery with concurrent CMA for valvular disease with AF.The patients were grouped based on whether they experienced a recurrence of AF,with 23 patients in the recurrence group and 92 in the non-recurrence group.General clinical data and relevant laboratory date were collected,and the preoperative burden of VPB(defined as more than 10000 VPBs per 24 hours)was assessed.The risk factors for AF recurrence following the procedure by univariate and multivariate Cox regression analysis were analyzed.Results:The burden of VPB in the recurrence group was significantly higher than that in non-recurrence group(P<0.05).The multivariate Cox regression analysis indicated that frequent VPB and diabetes were risk factors for the recurrence of AF after valvular surgery with concurrent CMA.Conclusion:Frequent VPB was risk factor for the recurrence of AF following valvular surgery with concurrent CMA.