探讨影响持续性心房颤动消融手术成功的因素及术中不同转窦方式对预后的影响

Factors Influencing the Success of Ablation of Persistent Atrial Fibrillation and the Effect of Different Sinus Transfer Methods on the Prognosis

摘要: 目的：探讨影响射频消融手术成功率的相关因素，以及术中不同转窦方式对持续性心房颤动患者预后的影响。方法：选自2017年1月至2022年1月期间在聊城市人民医院心内科住院的365例持续性心房颤动患者，按照不同的转复方式进行分组：消融 + 电复律转窦组(N = 260)、消融术中转窦组(N = 105)。1) 通过临床资料分析手术成功相关因素，并进一步运用logistic对相关因素进行分析，得出与手术成功相关的独立因素；2) 对两组患者进行随访分析，统计不同转窦方式术后6个月、12个月、18个月的复发率。结果：研究发现患者的左心房前后径、左室射血分数、年龄、吸烟史、饮酒史、卒中评分是手术成功的相关因素(P < 0.05)；进一步通过logistic回归分析显示：左心房前后径、饮酒史、卒中评分是影响射频手术成功的独立危险因素(P < 0.05)。射频消融成功组较电复律组术后6个月、12个月、18个月的复发率明显降低(P < 0.05)。结论：左心房前后径、饮酒史、卒中评分是影响射频手术成功的独立危险因素，射频消融成功组较电复律组术后复发率明显降低。

Abstract: Objective: To investigate the related factors affecting the success rate of radiofrequency ablation and the effect of different sinus transfer methods on the prognosis of patients with persistent atrial fibrillation. Methods: A total of 365 patients with persistent atrial fibrillation hospitalized in the Department of Cardiology, Liaocheng People’s Hospital from January 2017 to January 2022 were selected and divided into two groups according to different cardioversion methods: ablation + electrical cardioversion group (N = 260) and successful ablation group (N = 105). 1) The factors related to the success of the operation were analyzed by clinical data, and Logic was further used to analyze the relevant factors to obtain the independent factors related to the success of the operation; 2) Follow-up analysis was conducted for the two groups of patients, and the recurrence rates of different sinus transfer methods were counted at 6, 12 and 18 months after operation. Results: It was found that left atrial diameter, left ventricular ejection fraction, smoking history, drinking history and stroke score were related factors to the success of surgery (P < 0.05). Logistic regression analysis showed that left atrial diameter, drinking history, age and stroke score were independent risk factors for the success of radiofrequency surgery (P < 0.05). The recurrence rate of successful radiofrequency ablation group was significantly lower than that of electrical cardioversion group at 6 months, 12 months and 18 months after operation (P < 0.05). Conclusion: Left atrial diameter, history of alcohol consumption and stroke score are independent risk factors for the success of radiofrequency surgery. The recurrence rate of successful radiofrequency ablation group is significantly lower than that of electrical cardioversion group.