摘要
目的探讨饮酒程度对男性心房颤动（房颤）患者导管消融后房颤复发的影响。方法共连续入选初次进行射频消融治疗的男性房颤患者192例（持续性房颤64例，阵发性房颤128例），平均年龄（53．4±10．3）岁。排除患有瓣膜性心脏病、近3个月内发生心肌梗死、左心室射血分数（LVEF）〈0．50、甲状腺功能亢进，以及严重肝肾功能异常者。根据术前饮酒程度分为不饮酒、少中量饮酒和大量饮酒3组，并对比3组间临床特征及消融疗效的差异。进行单因素及Cox多元回归分析，评价房颤消融术后复发的预测因素。结果平均随访（17．7±6．1）个月，共66例（34．4％）患者复发房颤。其中，大量饮酒者（29．7％）的左心房内径显著增大，术后复发率显著增加。单因素分析显示饮酒、持续性房颤、2型糖尿病、CHADS：评分〉12、左心房扩大均与房颤消融术后复发显著相关。Cox多因素回归分析示，饮酒（HR=1．547，95％CI1．108～2．161，P=0．010），2型糖尿病（HR=1．939，95％CI1．038～3．622，P=0．038），左心房内径（HR=1．046，95％CI1．000—1．095，P=0．050）是房颤消融术后复发的独立预测因素。结论大量饮酒的房颤患者左心房内径明显扩大，其消融术后的复发率显著增加。饮酒程度能够独立预测消融术后房颤的复发。
Objective The aim of this study was to evaluate the association of alcohol consumption with the outcome of AF ablation among Chinese men. Methods The study involved 192 consecutive Chinese men who underwent catheter ablation of AF （64 patients with persistent AF）. Participants were categorized as non-drinkers, light or moderate drinkers, and heavy drinkers according to the amount of alcohol intake per week before the ablation. Results After a mean follow-up of （ 17.7 ±6. 1 ） months （5± 31 months）, 66 （ 34. 4% ） patients had recurrent AF after ablation. Heavy drinkers,found in 29.7% of candidates for AF ablation, had a significantly larger left atrial（LA） size and a higher incidence of recurrent AF after ablation compared to non- drinkers and light or moderate drinkers. In addition, alcohol consumption （HR= 1. 765,95% CI 1. 298 -2. 400, P〈O. 001 ）, persistent AF （HR = 1.64,95% CI 1. 006 -2. 673, P = 0. 047 ）, type 2 diabetes （HR = 2. 409,95 % CI 1. 332 ±4. 385, P =0. 004）, CHADS2 score ≥ 2 （ HR = 2. 0, 95 % CI 1. 090 ± 3. 672, P = 0. 025 ）, dilated LA （ HR= 1. 073,95% CI 1. 027- l. 120,P=0. 002） were significantly associated with AF recurrence after the proce- dure. Multivariate Cox regression analysis revealed that alcohol consumption （ HR = 1. 547,95% CI 1. 108 2. 161 ,P=0. 010） ,type 2 diabetes （ HR = 1. 939,95% CI 1. 038 - 3.622, P =0. 038） and LA size （ HR = 1. 046,95% CI 1. 000 - 1.095 ,P=0. 050） were independent predictors of recurrent AF after ablation. Conclusion Consuming heavier amounts of alcohol was associated with an increased risk of recurrent AF after catheter ablation among Chinese men. Alcohol consumption could independently predict the outcome of AF ablation.
出处
《中华心律失常学杂志》
2012年第4期297-301,318,共6页
Chinese Journal of Cardiac Arrhythmias
关键词
心房颤动
射频导管消融
饮酒
Atrial fibrillation
Radiofrequency catheter ablation
Alcohol consumption
