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首页> 外文期刊>Frontiers in Cardiovascular Medicine >Clinical Efficacy and Safety of Cox-Maze IV Procedure for Atrial Fibrillation in Patients With Hypertrophic Obstructive Cardiomyopathy
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Clinical Efficacy and Safety of Cox-Maze IV Procedure for Atrial Fibrillation in Patients With Hypertrophic Obstructive Cardiomyopathy

机译：肥厚性阻塞性心肌病患者心房颤动的Cox-Maze IV程序的临床疗效和安全性

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Objective: Atrial fibrillation is the most prevalent persistent arrhythmia in patients with hypertrophic obstructive cardiomyopathy. Comparative analyses of the safety and effectiveness of septal myectomy with and without surgical ablation are limited. This study aimed to compare the outcomes of septal myectomy with and without the Cox-maze IV procedure in patients with hypertrophic obstructive cardiomyopathy and atrial fibrillation. Methods: Ninety-four patients with hypertrophic obstructive cardiomyopathy and atrial fibrillation who underwent septal myectomy were analyzed, we divided it into concomitant Cox maze surgery (Cox-maze group) and no concomitant Cox maze operation (no Cox-maze group). Freedom from atrial fibrillation recurrence and all-cause mortality after surgery were assessed. Results: Freedom from all-cause mortality after septal myectomy at 1, 3, and 5 years was 98.5 ± 1.5% each in the Cox-maze group and 90.8 ± 6.3%, 85.1 ± 8.1%, and 85.1 ± 8.1%, respectively, in the no Cox-maze group. Patients in the no Cox-maze group had lower survival, freedom from atrial fibrillation recurrence off antiarrhythmic drugs, and arrhythmia control rate (including patients with successful antiarrhythmic drug conversion) than those in the Cox-maze group ( P = 0.046, P = 0.040, and P = 0.012, respectively). Patients who underwent the Cox-maze IV procedure had lower atrial fibrillation recurrence rate than those who did not (hazard ratio, 0.141; 95% confidence interval, 0.042–0.479; P = 0.002). Post-operative increases in left atrial diameters (hazard ratio, 1.099; 95% confidence interval, 1.024–1.179; P = 0.009) were associated with atrial fibrillation recurrence. Conclusions: The Cox-maze IV procedure combined with septal myectomy improved mid-term survival and reduced mid-term atrial fibrillation recurrence in patients with hypertrophic obstructive cardiomyopathy and atrial fibrillation. The concomitant Cox-maze IV procedure was associated with a lower atrial fibrillation recurrence in patients with surgical hypertrophic obstructive cardiomyopathy and atrial fibrillation.
机译：目的：心房颤动是肥厚性阻塞性心肌病患者中最普遍的持续心律失常。对细胞宫切除术的安全性和有效性的比较分析有限。本研究旨在比较肥厚性阻塞性心肌病和心房颤动患者的患者中间体宫切除术的结果。方法：分析了九十四名患有后期肌切除术的肥大障碍性心肌病和心房颤动的患者，我们将其分成伴随的COX迷宫手术（COX-迷宫组），没有伴随的COX迷宫操作（没有COX迷宫组）。评估手术后心房颤动复发和全因死亡率的自由。结果：在1,3和5年后的隔膜术后的全因死亡率的自由分别为98.5±1.5％，分别为90.8±6.3％，85.1±8.1％和85.1±8.1％，在没有Cox-Maze组。 NO COX-MAZE组的患者患者存活率降低，自由于心房颤动复发，脱硫药物，以及心律失常控制率（包括抗心律失常药物转化的患者）比COX-MAZE组（P = 0.046，P = 0.040）和p = 0.012分别）。接受Cox-Maze IV程序的患者具有比没有（危害比率为0.141; 95％的置信区间，0.042-0.479; p = 0.002）的心房颤动复发率较低的心房颤动复发率。左心房直径的术后增加（危险比，1.099; 95％置信区间，1.024-1.179; p = 0.009）与心房颤动复发有关。结论：Cox-Maze IV程序联合隔膜肌切除术改善的中期存活和减少患者中期的心房梗阻性心肌病和心房颤动的中期心房颤动复发。伴随的Cox-maze IV程序与手术肥厚性阻塞性心肌病和心房颤动患者的心房颤动复发较低。

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