衰弱与老年房颤患者导管消融术后复发的相关性研究
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1南京医科大学第一附属医院老年心血管科,江苏 南京 210029 ; 2.靖江市人民医院老年病科,江苏 靖江 214500 ; 3.南通市第三人民医院全科医学科,江苏 南通 226001 ; 4.南京医科大学第一附属医院心血管内科,江苏 南京 210029

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R541.75

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江苏省高等学校自然科学重大项目(21KJB320003);江苏省社会发展-临床前沿技术项目(BE2023818);江苏省老年健康科研重点项目(LKZ2023001);江苏省人民医院临床能力提升工程面上项目(JSPH-MB-2022-13)


Correlation of frailty and recurrence after catheter ablation in elderly patients with atrial fibrillation
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Department of Geriatric Cardiology,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029 ; 2.Department of Geriatrics,Jingjiang People’s Hospital,Jingjiang 214500 ; 3.Department of General Medicine,theThird People’s Hospital of Nantong,Nantong 226001 ; 4.Department of Cardiovascular Medicine,the First AffiliatedHospital of Nanjing Medical University,Nanjing 210029 ,China

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    摘要:

    目的:探讨衰弱与老年心房颤动(简称房颤)患者行导管消融术后房颤复发的关系。方法:前瞻性选择2023年6— 12月于南京医科大学第一附属医院、南通市第三人民医院、靖江市人民医院心血管内科行房颤导管消融手术的老年患者292例。 术前收集受试者基线资料,并根据Frail量表将受试者分为衰弱组(≥3分)、衰弱前期组(1~2分)及无衰弱组(0分),比较3组患者的组间差异。术后随访1年,根据随访期间是否出现房颤复发分为复发组和未复发组,对比2组临床资料,采用单因素及多因素Logistic回归分析衰弱与房颤导管消融术后复发之间的关系以及房颤复发的其他危险因素。通过Kaplan-Meier分析术后 1年的房颤复发事件累积发生率,Log-rank检验比较组间复发风险差异。结果:共纳入292例老年房颤患者,其中无衰弱组94例, 衰弱前期组138例,衰弱组60例。随访1年,共52例(17.8%)患者出现房颤复发,衰弱组的复发率较无衰弱组及衰弱前期组均明显升高[38.33%(23/60)vs. 10.64%(10/94)vs. 13.77%(19/138),P < 0.001]。多因素Logistic分析结果显示,在校正人口统计学资料和临床因素后,衰弱与老年房颤导管消融术后复发率高显著相关(OR=3.430,95% CI:1.219~10.233,P=0.032)。房颤类型(持续性房颤)、体重指数、N末端B型钠尿肽前体、左心房内径是老年房颤患者导管消融术后复发的独立危险因素(P均< 0.05)。结论:衰弱与老年房颤患者导管消融术后复发具有显著相关性,是房颤消融术后复发的可靠预测因子。

    Abstract:

    Objective:To explore the relationship between frailty and atrial fibrillation(AF)recurrence after catheter ablation in elderly AF patients. Methods:A prospective study was conducted,including 292 elderly patients who underwent catheter ablation for AF between June 2023 and December 2023 at the First Affiliated Hospital of Nanjing Medical University,the Third People’s Hospital of Nantong,and the People’s Hospital of Jingjiang. Baseline data were collected before the operation,and the patients were categorized based on the Frailty Scale into three groups:frail group(≥3 points),pre-frail group(1-2 points)and non-frail group(0 points). The differences among the groups were compared. After one year of follow-up,patients were divided into two groups based on whether AF recurrence occurred:the recurrence group and the non-recurrence group. The clinical characteristics of the two groups were compared, and univariate and multivariate logistic regression analyses were performed to assess the relationship between frailty and AF recurrence after catheter ablation,as well as other risk factors for AF recurrence. The cumulative incidence of AF recurrence within one year post-surgery was analyzed using Kaplan-Meier,and the log-rank test was used to compare the recurrence risk between groups. Results:A total of 292 elderly AF patients were included,with 94 in the non -frail group,138 in the pre -frail group,and 60 in the frail group. During the one-year follow-up,52 patients(17.8%)experienced AF recurrence. The recurrence rate in the frail group was significantly higher than in the non -frail and pre -frail groups[38.33%(23/60)vs. 10.64%(10/94)vs. 13.77%(19/138),P < 0.001]. Multivariate logistic regression analysis,after adjusting for demographic and clinical factors,showed that frailty was significantly associated with a higher recurrence rate of AF after catheter ablation(OR=3.430,95% CI:1.219-10.233,P=0.032). AF type(persistent AF),body mass index(BMI),N -terminal pro B -type natriuretic peptide(BNP),and left atrial diameter(LAD)were independent risk factors for AF recurrence after catheter ablation in elderly patients. Conclusion:Frailty is significantly associated with AF recurrence after catheter ablation in elderly AF patients,and can serve as a reliable predictor of AF recurrence following the post-ablation.

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何玉立,刘倩慧,王瀚,马亮,姚子俊,徐云凡,夏玉东,吴军.衰弱与老年房颤患者导管消融术后复发的相关性研究[J].南京医科大学学报(自然科学版),2025,45(6):854-862

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  • 收稿日期:2025-01-09
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  • 在线发布日期: 2025-06-10
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