消融导管压力变异性与心房颤动首次射频消融复发的相关性研究

苏昕; 宁彬; 杨文武; 陈帅; 葛慧娟; 任磊; 陶长桂

doi:10.12125/j.chj.202109025

消融导管压力变异性与心房颤动首次射频消融复发的相关性研究

Correlation between variability of catheter contact force measurements and recurrence of first radiofrequency ablation of atrial fibrillation

摘要

摘要:
目的探讨消融导管压力变异性与心房颤动（房颤）首次射频消融复发的相关性。
方法连续选取2019年8月～2020年8月阜阳市人民医院收治的首次行射频消融术的房颤患者69例，所有患者均在CARTO3系统下行房颤射频消融术并恢复窦性心律，术中对消融压力-时间曲线进行数据采集分析。术后定期随访，观察患者是否复发，根据术后随访的结果，将患者分为复发组与未复发组，对压力数据进行两组比较，探讨消融导管压力变异性与房颤首次射频消融复发的相关性。
结果所有患者术后平均随访14个月，房颤复发18例，未复发51例。复发组与非复发组有统计学意义的变量为左房前后径：（45 ± 7) vs.（39 ± 7） mm, P<0.05，首次发现房颤至手术时间 24（8，60）月 vs. 7（1，24）月, P<0.01），消融导管压力变异性（5.64 ± 0.59) vs. (5.06 ± 0.46), P<0.01，二元Logistic多因素回归分析显示消融导管压力变异性和左房前后径可做为房颤患者首次射频消融复发的独立预测因素，OR值、95%置信区间、P值分别为（9.489, 2.080～43.280，P<0.01）和（1.152，1.019～1.302， P<0.05）。
结论压力变异性及左房前后径可做为心房颤动患者首次行射频消融后房颤复发的预测因素。

Abstract:
AIM To explore the correlation between the variability of catheter contact force measurements and the recurrence of the first radiofrequency ablation of atrial fibrillation.
METHODS Sixty-nine patients with atrial fibrillation who underwent radiofrequency catheter ablation in Fuyang People’s Hospital from August 2019 to August 2020 were chosen for this study. All patients recovered sinus rhythm under the guidance of CARTO3 system for the first radiofrequency ablation and the force data were collected from the real-time contact force measurements. Patients were followed up regularly to observe the recurrence of atrial fibrillation after the ablation and they were divided into recurrence group and non-recurrence group. The correlation between the variability of catheter contact force measurements and the recurrence of the first radiofrequency ablation of atrial fibrillation was explored.
RESULTS In this study, all patients were followed up for an average of 14 months after ablation and 18 patients had recurrence of atrial fibrillation while 51 patients had no recurrence. The anterior and posterior diameter of the left atrial in the recurrent group and non-recurrent group was: （ 45 ± 7)vs. （ 39 ± 7） mm, P<0.05. The time from the first discovery of atrial fibrillation to ablation was 24 (8,60) months vs. 7 (1,24) months, P<0.01. Variability of ablation catheter contact force was （5.64 ± 0.59） vs. （5.06 ± 0.46）, P<0.01, Binary logistic multivariate regression analysis showed that the anterior and posterior diameter of the left atrial and the variability of ablation catheter contact force were independent predictors of the recurrence of the first of ablation in patients with atrial fibrillation. OR values, 95% confidence intervals and P values were 9.489, 2.080-43.280, P<0.01 and 1.152, 1.019-1.302, P<0.05.
CONCLUSION Variability of ablation catheter contact force and left atrial anterior posterior diameter can be used as predictors of atrial fibrillation recurrence after the first radiofrequency ablation.

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