心房颤动患者射频消融术后复发的危险因素研究

Study on Risk Factors for Recurrence after Radiofrequency Ablation in Patients with Atrial Fibrillation

摘要: 目的：探讨心房颤动患者经过射频消融治疗后复发的危险因素。方法：纳入于2019年1月至2020年1月就诊于青岛大学附属医院并行射频消融治疗的房颤患者96例，术后随访12个月，根据是否出现空窗期(术后3个月)后房颤复发分为复发组(n = 25)和非复发组(n = 71)，收集2组患者的临床资料，探索房颤复发的影响因素。结果：2组患者的年龄、性别、BMI、合并高血压病、冠心病、糖尿病、CHA2DS2-VASc评分、HAS-BLED评分、BNP水平无统计学差异，2组患者的房颤类型、房颤病程、左房前后径、左房容积指数、左心室射血分数、术中标测术中是否存在左房低电压区、血清尿酸、血清同型半胱氨酸水平存在统计学差异。多因素Logistic回归分析发现左房前后径、左房容积指数、存在左房低电压区、血清尿酸水平与射频消融术后房颤复发独立相关，其ROC曲线下面积及95%置信区间分别为0.942 (0.899~0.984)，0.801 (0.712~0.889)，0.957 (0.920~0.993)，0.644 (0.517~0.771)。结论：左房前后径大、左房容积指数高、存在左房低电压区、血清尿酸高与射频消融术后房颤复发独立相关。

Abstract: Objective: To explore the risk factors of recurrence after radiofrequency ablation in patients with atrial fibrillation. Methods: A total of 96 patients with atrial fibrillation, who were treated with radiofrequency ablation from January 2019 to January 2020, were enrolled into this study. All patients were divided into 2 groups according to the 12-month follow-up results after the surgery, including recurrence group (n = 25) and non-recurrence group (n = 71). Clinical data of 2 patients were collected to explore the influencing factors of AF recurrence. Results: There were no statistical differences in age, sex, BMI, hypertension, coronary heart disease, diabetes, CHA2DS2-VASc score, HAS-BLED score and BNP level, while there were significant statistical differences in types of atrial fibrillation, time of atrial fibrillation, left atrial diameter, left atrial volume index, left ventricular ejection fraction, LV low voltage area, serum uric acid and serum homocysteine levels. Multi-factor logistic regression analysis found that left atrial diameter, left atrial volume index, presence of left atrial low voltage area, serum uric acid levels were independently associated with AF recurrence after radiofrequency ablation, the area under the curve and 95% confidence interval of these factors were 0.942 (0.899~0.984), 0.801 (0.712~0.889), 0.957 (0.920~0.993), 0.644 (0.517~0.771). Conclusion: The large left atrial diameter, high left atrial volume index, presence low left atrial voltage area, high serum uric acid were independently associated with the recurrence of AF after radiofrequency ablation.