老年房颤患者导管射频消融疗效及复发相关因素分析
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江苏省卫生健康委员会课题(BJ17019)


Efficacy of catheter ablation and facfors related to recurrence in elderly patients with atrial fibrillation
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    摘要:

    目的:研究老年房颤患者导管射频消融的疗效及复发相关因素。方法:收集2013年1月—2016年12月于南京医科大学第一附属医院行房颤导管射频消融,且年龄≥60岁患者的临床资料,分析手术疗效、安全性及复发的相关因素。结果:共入组482例患者,年龄(66.5±4.7)岁。其中,男297例(61.6%),女185例(38.4%),阵发性房颤239例(49.6%),持续性房颤243例(50.4%)。围术期共4例穿刺局部并发症,无严重并发症发生。随访(20.4±5.6)个月,共104例(21.6%)患者房颤复发。房颤复发组与未复发组在左心房大小、糖尿病、心衰、房颤患者卒中风险评估评分(CHA2DS2-VASc)积分等因素存在显著差异(P < 0.05),两组年龄、性别、高血压病等因素无显著差异。结论:导管射频消融治疗老年房颤患者安全有效,左心房增大、合并糖尿病、心衰等可能与复发相关。

    Abstract:

    Objective:This study aims to analyze the real-world data regarding the effect of catheter ablation and the factors related to recurrence after ablation in elderly patients with atrial fibrillation. Methods:Elderly patients(≥60 years old)with atrial fibrillation receiving catheter ablation from January 2013 to December 2016 in our center were enrolled in this study. Clinical data were collected to confirm efficacy,safety,and recurrence-related factors of atrial fibrillation. Results:A total of 482 patients were eligible and the mean age of them was (66.5±4.7) years old. The study group included 297 males(61.6%)and 185 females(38.4%). There were 239(49.6%)patients diagnosed with paroxysmal atrial fibrillation,and the remains were persistent atrial fibrillation. There were 4 cases of perioperative complication and all of them were relevant to the venipuncture. The mean follow-up was (20.4±5.6) months. During the follow up,a total of 104(21.6%)patients experienced recurrence. The recurrent group and non-recurrent group were significantly different in left atrial diameter,diabetes,heart failure and CHA2DS2-VASc score(P < 0.05). There were no significant differences in age,gender,hypertension and other factors between the two groups. Conclusion:Catheter ablation of atrial fibrillation is safe and effective in elderly patients. Enlarged left atrium,and some comorbidities may be associated with recurrence of atrial fibrillation.

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褚 明,丁祥伟,王俊宏,顾周山,施姣姣.老年房颤患者导管射频消融疗效及复发相关因素分析[J].南京医科大学学报(自然科学版),2020,(12):1796-1799

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  • 收稿日期:2020-07-13
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  • 在线发布日期: 2021-01-04
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