摘要
目的:分析永久起搏器术后新发心房颤动的影响因素及临床预后。方法:回顾性分析于2010年1月到2012年12月期间,在北京安贞医院行双腔起搏器置入术的患者,对其长期随访。随访终点包括是否发生新发心房颤动和主要心脑血管不良事件。结果:共入选198例患者,42例(21.2%)在随访过程中检测到新发心房颤动,平均25.12个月,范围3~47个月,新发心房颤动患者的CHADS2评分[(2.05±1.08)vs.(1.28±1.12),P<0.001]和CHA_2DS_2-VASc评分[(3.59±1.54)vs.(2.74±1.44),P=0.001]显著高于未发生新发心房颤动患者,Cox回归分析显示,影响患者新发心房颤动的相关因素主要是年龄(P=0.005)、左心房增大(P=0.002)。Kaplan-Meier生存分析显示,新发心房颤动组的心力衰竭住院率(RR=4.697,P=0.005)、脑卒中发生率(RR=5.114,P=0.033)高于未发生新发心房颤动组。结论:年龄和左心房扩大是永久起搏器置入患者术后新发心房颤动的相关因素,新发心房颤动可增加患者的心力衰竭和脑卒中发生风险。
Objective： To evaluated the risk factors and prognosis of implanted pacemaker-identified new-onset atrial fibrillation（ AF）. Methods： 198 consecutive patients with newly implanted DDD pacemakers were retrospectively analyzed between January 2010 and December 2012 at Beijing Anzhen Hospital. Results：42（ 21. 2%） developed new AF during follow-up,mean follow-up 25. 12 months; range,3-47 months. Patients with new-onset AF had a significantly higher CHADS2 score[（ 2. 05 ± 1. 08） vs.（ 1. 28 ± 1. 12）,P 〈0. 001] and CHA2 DS2-VASc score [3. 59 ± 1. 54） vs.（ 2. 74 ± 1. 44）,P〈 0. 001] compared with those without new-onset AF. Age at implantation（ P = 0. 005） and larger left atrial（ P = 0. 002） was significantly correlated with new-onset AF on Cox regression analysis. The incidence of hospitalization due to heart failure（ RR = 4. 697,P = 0. 005） and new-onset stroke（ RR = 5. 114,P = 0. 033） was significantly higher in the new-onset AF than in the without new-onset AF group. Conclusion： Age and larger left atrial are two independent risk factor for pacemaker-identified AF. Pacemaker-identified AF was associate with an increased risk of heart failure and stroke.
出处
《心肺血管病杂志》
2018年第2期87-90,共4页
Journal of Cardiovascular and Pulmonary Diseases
关键词
心房颤动
影响因素
临床预后
起搏器
Atrial fibrillation
Risk factors
Prognosis
Pacemaker
