慢性心房颤动患者射频消融术后复发的影响因素分析

摘要

目的 探究慢性心房颤动(房颤)患者射频消融术后复发的影响因素.方法 回顾性分析郑州市第七人民医院心内科在2016年6月至2018年3月期间收治的110例慢性房颤患者射频消融术后的复发情况,并采用多因素Logistic回归分析射频消融术后复发的影响因素.结果 在3个月的随访中,共49例发生复发.复发组和未复发组患者的一般临床资料比较中,左心房前后径、左房内径指数等因素存在显著统计学差异(P＜0.05).多因素Logistic回归分析中,左心房前后径(OR=1.194,95%CI:1.097~1.299, P＜0.01)、左房内径指数(OR=2.669,95%CI:1.032~6.903,P=0.043)和持续性房颤(OR=0.071, 95%CI:0.021~0.246,P＜0.01)是房颤患者射频消融术后复发的影响因素.结论 房颤类型、左心房前后径以及左房内径指数是慢性房颤患者射频消融术后复发的影响因素,为减少慢性房颤患者术后的复发率应研究优化消融策略,以提高患者手术成功率.%Objective To investigate the influencing factors of recurrence of chronic atrial fibrillation (CAF) after radiofrequency ablation (RFA). Methods CAF patients (n=110) were chosen from the Department of Cardiology of the Seventh People’s Hospital of Zhengzhou City from June 2016 to Mar. 2018, and their recurrence situations were retrospectively analyzed after RFA. The influencing factors of CAF recurrence were analyzed by applying multi-factor Logistic regression analysis. Results During the follow-up period for 3 months, the recurrence was occurred in 49 cases. The comparison in general data between recurrence group and non-recurrence group showed that there were greatly significant statistical differences in left atrial anteroposterior diameter (LAAPD) and left atrial diameter index (LADI, P<0.05). The results of multi-factor Logistic regression analysis indicated that LAAPD (OR=1.194, 95%CI: 1.097~1.299, P<0.01), LADI (OR=2.669, 95%CI: 1.032~6.903, P=0.043) and persistent atrial fibrillation (OR=0.071, 95%CI: 0.021~0.246, P<0.01) were influencing factors of CAF recurrence in CAF patients after RFA. Conclusion The types of atrial fibrillation, LAAPD and LADI are influencing factors of CAF recurrence in CAF patients after RFA. In order to reduce CAF recurrence rate and improve RFA success rate, the ablation strategy should be optimized.