[1]樊永强吕华胜 刘佳琦汤宝鹏 周贤惠 李耀东 邢强 张疆华 芦颜美.心房颤患者左心耳与导管消融后复发的相关性：单中心研究[J].心血管病学进展,2023,(10):949.[doi:10.16806/j.cnki.issn.1004-3934.202.10.019]
　FAN Yongqiang,LIU Jiaqi,LYU Huasheng,et al.Correlation Between Left Atrial Appendage Dysfunction and Recurrence after Catheter Ablation in Patients with Atrial Fibrillation:A Single Center Study[J].Advances in Cardiovascular Diseases,2023,(10):949.[doi:10.16806/j.cnki.issn.1004-3934.202.10.019]
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心房颤患者左心耳与导管消融后复发的相关性：单中心研究()
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《心血管病学进展》[ISSN:51-1187/R/CN:1004-3934]

卷:
期数:
2023年10期
页码:
949
栏目:
论著
出版日期:
2023-10-25

文章信息/Info

Title:
Correlation Between Left Atrial Appendage Dysfunction and Recurrence after Catheter Ablation in Patients with Atrial Fibrillation:A Single Center Study
作者:
樊永强1吕华胜1 刘佳琦汤宝鹏1 周贤惠1 李耀东1 邢强1 张疆华1 芦颜美1
(1.新疆医科大学第一附属医院心脏中心起搏电生理科，新疆 乌鲁木齐 830054；2.曹县人民医院心内科，山东 菏泽 274400）
Author(s):
FAN Yongqiang1; 2; LIU Jiaqi3; LYU Huasheng1; TANG Baopeng1; ZHOU Xianhui1; LI Yaodong1; XING Qiang1; ZHANG Jianghua1; LU Yanmei1
(1.Department of Pacing and Electrophysiology,The First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,Xinjiang,China; 2.The Fifth Hosipital of Jinan University(Heyuan Shenhe Peoples Hospital),Heyuan 517000,Guangdong,China; 3.Department of Cardiology,Caoxian Peoples Hospital,Heze 274400,Shandong,China)
关键词:
心房颤动; 左心耳; 导管消融
Keywords:
Atrial fibrillation;  Left atrial appendage velocity;  Catheter ablation
DOI:
10.16806/j.cnki.issn.1004-3934.202.10.019
摘要:
目的?探讨左心耳（LAAV）与首次导管消融后复发的相关性。方法?回顾性分析了2019年6月2021年6月在首次进行导管消融的患者。术前使用记录LAAV，评估患者左心耳功能，收集患者的基本临床数据。并对纳入的患者随访1年。采用Cox风险比例模型来确定在复发中的预测价值。结果?本研究共纳入268例患者，平均年龄60.10±11.11岁，49例患者出现复发。发生复发的患者多为持续性（P=0.001），45°左心耳深度较深（28.06±7.09 mm vs 26.01±6.11 mm，P=0.04），LAAV较低（0.51±0.22 m/s vs 0.59±0.22 m/s，P =0.033），通过ROC曲线分析在LAAV=0.495 m/s时对复发具有最佳的检验效能，并以此将患者分为正常组和组。通过Kaplan-Meier曲线分析，组与正常组相比，（Long-rank P =0.004），Cox比例风险模型显示持续性（HR=1.92995% CI 1.017~3.658,P=0.044）、（HR=1.09495% CI 1.005~1.192,P=0.038）、LAAV0.495 m/s（HR=1.94795% CI 1.034~3.664,P=0.039）是影响复发的独立危险因素。在亚组分析中，无论阵发性患者是持续性患者均未发现导管消融后复发的独立危险因素。结论?可能是导管消融后复发的潜在危险因素。
Abstract:
Objective To investigate the correlation between left atrial appendage and recurrence after first catheter ablation in patients with atrial fibrillation(AF). Methods Patients with atrial fibrillation who underwent catheter ablation for the first time in The First Affiliated Hospital of Xinjiang Medical University from June 2019 to June 2021 were analyzed retrospectively. Before operation,The left atrial appendage velocity was obtained by transesophageal echocardiography to evaluate the function of left atrial appendage,and collect other basic clinical data of patients. All the patients were followed up for 1 year. The left atrial appendage velocity was tested using a Cox proportional hazards regression analysis as predictors of AF recurrence. Results 268 patients were enrolled in this study,with an average age of 60.10 ± 11.11 years. A total of 49 patients had atrial fibrillation recurrence. Patients with recurrence were more persistent atrial fibrillation (P=0.001),the depth of left atrial appendage was deeper at 45°(28.06±7.09 mm vs 26.01±6.11 mm,P=0.04),and LAAV was lower (0.51±0.22 m/s vs 0.59±0.22 m/s,P=0.033). The ROC curve analysis showed that LAAV=0.495 m/s was the best test for recurrence of atrial fibrillation,and patients were divided into left atrial appendage velocity normal group and left atrial appendage velocity lower group. Kaplan Meier curve analysis showed that the recurrence rate of atrial fibrillation in the velocity lower group was higher than that velocity normal group (Long rank P=0.004). Cox proportional risk model showed that persistent atrial fibrillation (HR=1.929,95% CI 1.017~3.658,P=0.044),body mass index (HR=1.094,95% CI 1.005~1.192,P=0.038),LAAV≤0.495 m/s (HR=1.947,95% CI 1.034~3.664,P=0.039) were independent risk factors in the recurrence of atrial fibrillation after catheter ablation. In subgroup analysis,no independent risk factors for recurrence of atrial fibrillation after catheter ablation were found in patients with paroxysmal atrial fibrillation or persistent atrial fibrillation. Conclusion Left atrial appendage velocity reducing may be a potential risk factor for recurrence of atrial fibrillation after catheter ablation

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备注/Memo

备注/Memo:
收稿日期：2023-04-18基金项目：新疆省天山英才-青年拔尖科技人才项目（2022TSYCCX0101）
更新日期/Last Update: 2023-11-15