摘要
目的 确定阵发性心房颤动 (房颤 )局灶性消融治疗后复发的危险因素与预测因子。方法 连续 74例接受局灶性消融治疗的阵发性房颤 ,通过单因素和多因素分析对 11项临床和射频消融指标与房颤复发之间的关系进行研究。结果 平均随访 (12 4± 6 6 )个月 ,5 1例 (6 8 9% )房颤复发。单因素分析确定的与复发有关的因素包括 :年龄 [(5 3 0± 13 9)对 (4 5 0± 11 6 )岁 ,P <0 0 5 ]、左心房前后径 [(39± 5 )对 (36± 3)mm ,P =0 .0 1]、异位灶数目 [(1.6± 0 .7)对 (1.2± 0 .4)个 ,P <0 .0 1]和总X线透视时间 [(4 3± 9)对 (38± 9)min ,P <0 0 5 ]等 4种 ;但经Logistic多因素逐步回归分析后仅有异位灶数目 (OR 3 7;95 %CI 1 2～ 11 1;P <0 0 5 )和左心房前后径 (OR 1 2 ;95 %CI 1 0～ 1 4;P <0 0 5 )为消融后复发的独立预测因子。
Objec tive To determine the pred ictors and risk factors of recurrence af ter focal ablation of initiating trigger s and beats in patients with paroxysmal atrial fibrillation(AF). Methods Eleven clinical and procedural variable s in 74 consecutive paroxysmal AF patie nts undergone focal ablation of init iating triggers were analyzed retrospect ively.Univariate and multivariate analys is were used to investigate the relation ship between the recurrence of AF and th ese factors. Results After a mean follow up of (12 4±6 6)month s,AF recurred in 51 patients(68 9%).Univar iate analysis revealed that age [(53 0±13 9)vs(45 0±11 6)yrs,[WT BX ]P<0 05],anterior posterior l e ft atrium (LA)dimension,anterior posterior l e ft atrium (LA)dimension[(39 ±5)vs(36±3)mm,P= 0 01] ,number of foci[(1 6±0 7)vs(1 2± 0 4),P<0 01],and total fl uoroscopic time[(43±9)vs (38±9)min,P<0 05] were risk factors of recurrent AF.H owever,stepwise multivariate regression analysis indentified only anterior poste rior LA dimension(OR 1 2;95% CI 1 0～ 1 4;P<0 05)and number o f foci( OR 3 7;95% CI 1 2～11 1,P<0 0 5)were the significant and independent predictors of recurrent AF.Conclusion Multiple foci and LA enlargement are the independent p redictors of recurrence after focal abla tion of paroxysmal AF.
出处
《中华心律失常学杂志》
2002年第1期38-41,共4页
Chinese Journal of Cardiac Arrhythmias
关键词
阵发性心房颤动
导管消融
复发
危险因素
Atrial fibrillation
Catheter ablatio n
Recurrence
Risk factor
