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首页> 外文期刊>Congenital heart disease. >Predictors and rates of recurrence of atrial arrhythmias following catheter ablation in adults with congenital heart disease
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Predictors and rates of recurrence of atrial arrhythmias following catheter ablation in adults with congenital heart disease

机译：在具有先天性心脏病的成人中导管消融后心房心律失常复发的预测因子和复发率

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Abstract Background Catheter ablation is commonly performed to treat atrial arrhythmias in adult congenital heart disease (ACHD). Despite the frequency of ablations in the ACHD population, predictors of recurrence remain poorly defined. Objective We sought to determine predictors of arrhythmia recurrence in ACHD patients following catheter ablation for atrial arrhythmias. Methods We performed a retrospective study of all catheter ablations for atrial arrhythmias performed in ACHD patients between January 12, 2005 and February 11, 2015 at our institution. Prespecified exposures of interest and time from ablation to recurrence were determined via chart review. Results Among 124 patients (mean age: 45 years) who underwent catheter ablation, 96 (77%) were treated for macro‐reentrant atrial tachycardia, 10 (7%) for focal atrial tachycardia, 9 (7%) for atrial fibrillation, 7 (6%) for atrioventricular nodal reentrant tachycardia, and 2 (2%) for atrioventricular reentrant tachycardia. 15 (12%) required transseptal/transbaffle puncture. Fifty‐one percent of patients recurred with a median time to recurrence of 1639 days. By univariate and multivariable analysis, body mass index (BMI) and Fontan status were the only variables associated with recurrence. Dose‐dependent effect was observed with overweight (HR = 2.37, P = .012), obese (HR = 2.67, P = .009), and morbidly obese (HR = 4.23, P = .003) patients demonstrating an increasing risk for arrhythmia recurrence postablation. There was no significant different in recurrence rates by gender, age, non‐Fontan diagnosis, or need for transseptal puncture. Conclusions In our cohort of ACHD patients, BMI was a significant risk factor for arrhythmia recurrence postablation, independent of Fontan status. These findings may help guide treatment decisions for persistent arrhythmias in the ACHD population.
机译：摘要背景导管烧蚀通常进行以治疗成人先天性心脏病（ACHD）的心房心律失常。尽管ACHD人群中的消融频率，但复发的预测因子仍然定义不足。目的我们试图确定疼痛患者心律失常复发的预测因子，治疗心房心律失常导管烧蚀后。方法对2015年1月12日至2015年2月11日在我们的机构进行的ACHD患者中进行心房心律失常的所有导管消融的回顾性研究。通过图表审查确定了从消融到复发的兴趣和时间的预先曝光。结果124名患者（平均年龄：45岁）接受导管消融的患者烧蚀，96（77％）对宏观重圈心房心动过缓，10（7％）用于局灶性心房，9（7％）进行心房颤动，7 （6％）用于房室结节释放性心动过速，2（2％）用于房室克雷卡病皮卡蔓。 15（12％）所需的跨拖船/拖动网燕燕燕燕燕燕盖穿刺。五十一百分之一的患者，中位时间重新发生1639天。通过单变量和多变量分析，体重指数（BMI）和Fontan状态是与再次发生相关的唯一变量。观察到剂量依赖性效果（HR = 2.37，P = .012），肥胖（HR = 2.67，P = .009），病态肥胖（HR = 4.23，P = .003）患者患者呈现出越来越大的风险心律失常复发延期。通过性别，年龄，非Fontan诊断或递推刺穿的需求没有显着不同。结论在我们的ACHD患者队列中，BMI是心律失常复发后的显着风险因素，独立于Fontan状态。这些发现可能有助于指导ACHD人口中持续心律失常的治疗决策。

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