Abstract:

Objective　To explore the risk factors of late recurrence in patients with atrial fibrillation after radiofrequency ablation. Methods　Ninety-five patients with atrial fibrillation treated by radiofrequency ablation in the Third Department of Cardiology of the Second People's Hospital of Liaocheng from May 2018 to July 2021 were selected, including 66 males and 29 females, aged (61.24±7.66) years. The patients were followed up postoperatively for one year and at regular intervals every three months, and the late recurrences were recorded. The general clinical data such as patients' age and gender, whether they had underlying diseases such as diabetes mellitus and hypertension, and ECG indicators were collected. The risk factors affecting patients' postoperative late recurrence were analyzed by univariate analysis (χ² test and independent sample t test) and multivariate logistic regression analysis. Results　There were 27 cases of postoperative late recurrence in the 95 patients who underwent radiofrequency ablation, accounting for 28.42%. Univariate analysis showed that there were no statistically significant differences in the gender, age, smoking history, hypertension, coronary heart disease, blood platelet count, triglyceride (TG), hemoglobin, alanine aminotransferase, fibrinogen, and left ventricular ejection fraction (LVEF) between the two groups (all P>0.05); the duration of disease [(5.81±1.45) years], proportion of diabetes [70.37% (19/27)], body mass index (BMI) [(24.77±2.75) kg/m²], left atrial diameter (LAD) [(41.25±6.16) mm], proportion of persistent atrial fibrillation [59.26% (16/27)], and proportion of intraoperative electrocardioversion [55.56% (15/27)] in the recurrence group were higher than those in the non-recurrence group [(4.97±1.24) years, 17.65% (12/68), (23.31±2.59) kg/m², (38.43±4.81) mm, 11.76% (8/68), and 16.18% (11/68)], with statistically significant differences (all P<0.05). Multivariate logistic regression analysis showed that long course of disease (OR=2.147), persistent atrial fibrillation (OR=2.338), and intraoperative electrocardioversion (OR=1.875) were independent risk factors for late recurrence of atrial fibrillation after radiofrequency ablation (all P<0.05). Conclusion　Long disease duration, persistent atrial fibrillation, and intraoperative electrocardioversion are the independent risk factors affecting the occurrence of late recurrence after radiofrequency ablation in patients with atrial fibrillation, therefore, the patients should be treated promptly and the conditions should be controlled clinically.

Key words:

Atrial fibrillation, Radiofrequency ablation, Late recurrence, Influencing factors

摘要：

目的　探究心房颤动（房颤）患者射频消融术后晚期复发的危险因素。方法　回顾性选取2018年5月至2021年7月聊城市第二人民医院心内三科收治的房颤行射频消融术治疗患者95例，其中男66例、女29例，年龄（61.24±7.66）岁。术后对患者进行为期1年的随访，每3个月定期进行1次随访，记录患者晚期复发情况。收集患者年龄、性别等一般临床资料及是否糖尿病、高血压等基础性疾病、心电图指标等资料。采用单因素分析（χ²检验、独立样本t检验）、多因素logistic回归分析影响患者术后晚期复发的危险因素。结果　95例行射频消融术患者中术后出现晚期复发27例，占28.42%。单因素分析结果显示，两组患者性别、年龄、吸烟史、合并高血压、合并冠心病、血小板计数、三酰甘油（TG）、血红蛋白、谷丙转氨酶、纤维蛋白原、左心室射血分数（LVEF）比较，差异均无统计学意义（均P>0.05）；复发组患者病程［（5.81±1.45）年］、合并糖尿病占比［70.37%（19/27）］、体质量指数（BMI）［（24.77±2.75）kg/m²］、左心房内径（LAD）［（41.25±6.16）mm］、持续性房颤占比［59.26%（16/27）］、术中电复律占比［55.56%（15/27）］均高于未复发组［（4.97±1.24）年、17.65%（12/68）、（23.31±2.59）kg/m²、（38.43±4.81）mm、11.76%（8/68）、16.18%（11/68）］，差异均有统计学意义（均P<0.05）。多因素logistic回归分析结果显示，病程较长（OR=2.147）、持续性房颤（OR=2.338）、术中电复律（OR=1.875）是影响房颤患者射频消融术后晚期复发的独立危险因素（均P<0.05）。结论　病程长、持续性房颤、术中电复律是影响房颤患者射频消融术后出现晚期复发的独立危险因素，临床应及时进行治疗、控制病情发展。

关键词:

心房颤动, 射频消融术, 晚期复发, 影响因素