摘要
目的探究右心耳(RAA)触发灶心房颤动(房颤)患者的临床特征及消融后随访结果。方法本研究为队列研究。回顾性收集2020年10月至2023年10月于南京医科大学第一附属医院心血管内科接受导管消融的房颤患者。所有患者先行环肺静脉隔离(CPVI)+非肺静脉触发灶消融。根据是否有RAA触发灶将患者分为RAA触发灶组与非RAA触发灶组。两组患者的年龄、性别、体重指数、左心房内径(LAD)、房颤类型、房颤病程及随访时间作为协变量进行1∶1倾向性评分匹配(PSM),匹配后分析两组的基线特征及术中参数差异。结果PSM后,RAA触发灶组与非RAA触发灶组各有22例患者,其中RAA触发灶组年龄(58.3±8.5)岁,年龄范围34~69岁,男14例;非RAA触发灶组年龄(59.4±7.8)岁,年龄范围45~73岁,男13例。两组患者的年龄、性别、合并症、房颤类型及房颤病程均差异无统计学意义(P>0.05)。与非RAA触发灶组相比较,RAA触发灶组的右心房容积(RAV)显著增大[82.10(68.30,94.39)ml对66.09(50.72,81.04)ml,P=0.035],房颤周长显著缩短[(137.3±1.6)ms对(178.7±4.4)ms,P<0.001],且总体手术时间显著延长[190.00(172.50,237.50)min对170.00(150.00,180.00)min,P=0.003]。中位随访14.00(10.75,15.25)个月,两组患者术后房颤复发率差异无统计学意义[18.18%(4/22)对4.55%(1/22),P=0.342]。结论RAA触发灶房颤患者RAV相对较大、房颤周长显著缩短,且手术时间延长,但预后与非RAA触发灶患者相似。
Objective To investigate the clinical features and follow-up results of patients with right atrial appendage(RAA)-triggered atrial fibrillation(AF).Methods This was a retrospective cohort study.Patients with AF who underwent catheter ablation in Department of Cardiology,The First Affiliated Hospital of Nanjing Medical University from October 2020 to October 2023 were collected.All patients were treated with circumferential pulmonary vein isolation(CPVI)+non-pulmonary vein triggered focal ablation.Patients were divided into RAA-triggered group and non-RAA-triggered group according to whether they had RAA trigger.In this study age,sex,body mass index,left atrial diameter,type of AF,duration of AF and follow-up time were used as covariables for 1∶1 propensity score matching(PSM)and the differences in baseline characteristics and intraoperative parameters between the two groups were analyzed.Results After PSM,there were 22 patients in the RAA-triggered group and 22 patients in the non-RAA-triggered group,including 14 males in the RAA-triggered group aged(58.3±8.5)years,ranging from 34 to 69 years,and 13 males in the non-RAA-triggered group aged(59.4±7.8)years,ranging from 45 to 73 years.There were no significant differences in age,sex,comorbidities,AF type and AF course between the two groups(P>0.05).Compared with the non-RAA-triggered group,the right atrial volume(RAV)in the RAA-triggered group was significantly increased[82.10(68.30,94.39)ml vs.66.09(50.72,81.04)ml,P=0.035].The AF cycle length(CL)was significantly shortened[(137.3±1.6)ms vs.(178.7±4.4)ms,P<0.001].The total operation time of RAA-triggered group was significantly prolonged[190.00(172.50,237.50)min vs.170.00(150.00,180.00)min,P=0.003].After 14.00(10.75,15.25)months follow-up,there was no significant difference in the recurrence rate of AF between the two groups[18.18%(4/22)vs.4.55%(1/22),P=0.342].Conclusion In patients with RAA-triggered AF,RAV is relatively large,AF CL is significantly shortened,and operation time is prolonged,but the prognosis
作者
沈寿美
薄丹
董艳
陈求实
蒋莉
何源
陈明龙
曹克将
张凤祥
Shen Shoumei;Bo Dan;Dong Yan;Chen Qiushi;Jiang Li;He Yuan;Chen Minglong;Cao Kejiang;Zhang Fengxiang(Department of Cardiology,The First Affiliated Hospital of Nanjing Medical University(Jiangsu Province Hospital),Nanjing 210029,China)
出处
《中华心律失常学杂志》
2024年第3期212-217,共6页
Chinese Journal of Cardiac Arrhythmias
基金
江苏省第6期333人才工程课题(2022-2-408)。
关键词
心房颤动
导管消融
右心耳
倾向性评分匹配
复发
Atrial fibrillation
Catheter ablation
Right atrial appendage
Propensity score matching
Recurrence
