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首页> 外文期刊>The American Journal of Cardiology >Predictors of atrial fibrillation termination and clinical success of catheter ablation of persistent atrial fibrillation
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Predictors of atrial fibrillation termination and clinical success of catheter ablation of persistent atrial fibrillation

机译：房颤终止的预测因素和持续性房颤导管消融的临床成功

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The termination of persistent atrial fibrillation (AF) during catheter ablation has been associated in some, but not all, studies with reduced arrhythmia during clinical follow-up. We sought to determine the rate of persistent AF termination achievable with a stepwise ablation strategy, the predictors of AF termination, and the clinical outcomes associated with termination and nontermination. A total of 143 consecutive patients (age 62 ± 9 years, AF duration 5.7 ± 5.2 years) with persistent and longstanding persistent AF resistant to antiarrhythmic medication who presented in AF for catheter ablation were studied. Ablation was done with a stepwise approach, including pulmonary vein isolation, followed by complex fractionated atrial electrogram ablation and ablation of resultant atrial tachycardias. Clinical follow-up was then performed after a 2-month blanking period to assess arrhythmia recurrence, defined as AF or atrial tachycardia lasting <30 seconds. AF termination by ablation was achieved in 95 (66%) of the 143 patients. Multivariate predictors of AF termination included longer baseline AF cycle length (p <0.001) and smaller left atrial size (p = 0.002). AF termination by ablation was associated with both a lower incidence of arrhythmia recurrence after a single procedure without antiarrhythmic drugs (p = 0.01) and overall clinical success (single or multiple procedures, with or without antiarrhythmic drugs; p = 0.005). On multivariate analysis, the predictors of overall clinical success included AF termination by ablation (p = 0.001), a shorter ablation duration (p = 0.002), younger age (p = 0.02), male gender (p = 0.03), and the presence of hypertension (p = 0.03). In conclusion, among patients with persistent AF, termination of AF by ablation can be achieved in most patients and is associated with reduced recurrence of arrhythmia.
机译：在一些但并非全部研究中，在导管消融期间终止持续性心房纤颤（AF）与临床随访期间心律失常减少有关。我们试图确定采用逐步消融策略可达到的持续性房颤终止率，房颤终止的预测因子以及与终止和非终止相关的临床结局。研究了总共143例持续且长期持续的抗心律失常药物耐药的房颤患者（年龄62±9岁，房颤持续时间5.7±5.2年），他们接受房颤消融治疗。消融是通过逐步方法进行的，包括肺静脉隔离，然后进行复杂的分级心电图消融，以及消融所得心房心动过速。在两个月的消隐期后，进行临床随访以评估心律失常的复发，定义为持续时间<30秒的房颤或房性心动过速。 143例患者中有95例（66％）通过消融实现了AF终止。 AF终止的多因素预测因素包括更长的基线AF周期长度（p <0.001）和较小的左心房大小（p = 0.002）。在没有抗心律失常药物的单次手术后，通过消融终止房颤与较低的心律失常复发发生率（p = 0.01）和整体临床成功率（有或没有抗心律失常药物的单次或多次手术; p = 0.005）。在多变量分析中，总体临床成功的预测因素包括通过消融终止房颤（p = 0.001），消融持续时间较短（p = 0.002），年龄较小（p = 0.02），男性（p = 0.03）和存在高血压（p = 0.03）。总之，在持续性房颤患者中，大多数患者可通过消融终止房颤，并与心律失常的复发减少相关。

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