作者：廉玉蓉，王芳，段续敏，刘念

单位：

1.041000山西省临汾市，山西医科大学第七临床医学院 临汾市人民医院心内科　2.100029北京市，首都医科大学附属北京安贞医院心律失常中心

Units：

1.Department of Cardiology, Linfen People's Hospital/Seventh Clinical School of Shanxi Medical University, Linfen 041000,China2.Center for Arrhythmias, Beijing Anzhen Hospital Affiliated to Capital Medical University, Beijing 100029, China

关键词：

心房颤动；持续性心房颤动；射频消融术；复发；影响因素分析

Keywords：

Atrial fibrillation; Persistent atrial fibrillation; Radiofrequency ablation; Recurrence; Root cause analysis

CLC：

R 541.75

DOI：

10.12114/j.issn.1008-5971.2023.00.227

Funds：

山西省卫生健康委科研课题（2020159）

摘要：

目的　探讨持续性心房颤动患者首次射频消融术后1年复发的影响因素。方法　选取2019—2021年在临汾市人民医院首次行射频消融术的持续性心房颤动患者96例。收集患者临床资料、术中消融终止心房颤动情况和冷盐水灌注射频消融导管类型。所有患者术后定期（1、3、6、12个月）进行门诊随访，记录其术后3个月内发生心房颤动或心房扑动及术后1年复发情况。根据术后1年复发情况将患者分为复发组（n=21）和未复发组（n=72）。持续性心房颤动患者首次射频消融术后1年复发的影响因素分析采用多因素Logistic回归分析。结果　随访期间，2例患者失访、1例患者术后3个月猝死，共93例患者完成随访，其中复发21例，复发率为22.6%（21/93）。复发组与未复发组患者心房颤动类型、冷盐水灌注射频消融导管类型及术后3个月内发生心房颤动或心房扑动者占比比较，差异有统计学意义（P＜0.05）。多因素Logistic回归分析结果显示，术后3个月内发生心房颤动或心房扑动是持续性心房颤动患者首次射频消融术后1年复发的危险因素〔OR=8.158，95%CI（2.445，27.227），P＜0.05〕。结论　术后3个月内发生心房颤动或心房扑动是持续性心房颤动患者首次射频消融术后1年复发的危险因素。

Abstract：

Objective To investigate the influencing factors of recurrence one-year after first radiofrequency ablationin patients with persistent atrial fibrillation. Methods A total of 96 patients with persistent atrial fibrillation who underwentfirst radiofrequency ablation in Linfen People's Hospital from 2019 to 2021 were selected. The clinical data, termination of atrialfibrillation by intraoperative ablation, the classification of cold saline perfusion radiofrequency ablation catheter of patients werecollected. All patients were followed up regularly (1, 3, 6 and 12 months) , and the occurrence of atrial fibrillation or atrial flutterwithin 3 months after operation and the recurrence one-year after operation were recorded. They were divided into recurrentgroup (n=21) and non-recurrent group (n=72) according to whether there was recurrence one-year after first radiofrequencyablation. Multivariate Logistic regression analysis was used to analyze the influencing factors of recurrence one-year after the firstradiofrequency ablation in patients with persistent atrial fibrillation. Results During the follow-up period, 2 patients were lostto follow-up and 1 patient died of sudden death at 3 months after operation. A total of 93 patients completed follow-up, of which21 cases recurred, with a recurrence rate of 22.6% (21/93) . There were significant differences in the type of atrial fibrillation,the classification of cold saline perfusion radiofrequency ablation catheter and the proportion of patients with atrial fibrillation oratrial flutter within 3 months after operation between the recurrence group and the non-recurrence group (P < 0.05) . MultivariateLogistic regression analysis showed that atrial fibrillation or atrial flutter within 3 months after operation was a risk factor forrecurrence one-year after first radiofrequency ablation in patients with persistent atrial fibrillation [OR=8.158, 95%CI (2.445,27.227) , P < 0.05] . Conclusion Atrial fibrillation or atrial flutter within 3 months after surgery is a risk factor for recurrence one-year after the first radiofrequency ablation in patients with persistent atrial fibrillation.

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