Objective To assess the influence of metabolic syndrome(MS)on the success rate of catheter ablation for the treatment of atrial fibrillation (AF)in the elderly. Methods A retrospective study included a total of 221 aged patients with AF who underwent AF ablation for the first time. The patients were divided into two groups :an MS group(n＝72)and a control group(without MS)(n＝149) . The MS group had a mean age of (67.1 ± 5.2) years ;the control group had a mean age of (68.3 ± 5.7) years. Forty-six patients in the MS group and 105 patients in the control group experienced paroxysmal atrial fibrillation. Prognoses in two groups were compared at the end of the follow-up. Results At the end of the follow-up ,the success rates of the procedure in the MS group and the control group were 37.5%(n ＝ 27)and 51.7%(n ＝ 77) ,respectively (χ2＝ 3.917 ,P ＝ 0.049) .Recurrence happened in 19 patients of the MS group and 28 patients of the control group ,and they underwent a repeat ablation. The overall success rates after the last ablation in the two groups were 51.4%(n＝37)and 65.8%(n＝98) ,respectively (χ2＝4.224 ,P＝0.034).In the multivariable model adjusted for risk factors ,MS(HR＝1.42 ,95% CI :1.11-1.64 ,P＝0.033)and left atrial diameter(HR＝ 1.83 ,95% CI :1.27-3.19 , P ＝ 0.017 ) were independent predictors for recurrence. Conclusions MS can affect the success rate of catheter ablation for AF in elderly patients and the effect remains even after the procedures are repeated%目的 探讨老年心房颤动(房颤)患者并存代谢综合征对导管消融成功率的影响. 方法 回顾性研究,入选2012年1月至2015年12月首次接受导管消融的221例老年房颤患者,根据患者临床资料分为代谢综合征组72例,年龄(67.1 ± 5.2)岁,其中阵发性房颤46例;非代谢综合征组(对照组)149例,年龄(68.3 ± 5.7 )岁,其中阵发性房颤105例.比较随访结束时两组患者的临床预后. 结果 随访结束时,代谢综合征组及对照组手术成功率分别为 27 例(37.5%)与 77 例(51.7%) ,差异有统计学意义(χ2＝3.917 ,P＝0.049 ) ;复发的患者中,两组分别有42.2%(19/45)和38.9%(28/72)患者进行了2次消融.最后一次消融后分别有37例(51.4%) ,98例(65.8%)的患者维持窦性心律(χ2＝4.224 ,P＝0.034 ) .多变量回归分析结果显示,代谢综合征( H R＝1.42 ,95%CI :1.11～1.64 ,P＝0.033)、左心房前后径(HR＝1.83 ,95%,CI :1.27～3.19 ,P＝0.017)是房颤导管消融术后长期随访复发的独立危险因素. 结论 代谢综合征影响老年房颤患者导管消融的成功率,即便是多次手术后,这一影响仍然存在.
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