摘要/Abstract
摘要： 目的 ·描述合并慢性病的老年心房颤动（房颤）患者经消融术后房颤复发率，探讨其相关因素。方法 ·采用方便抽样法选择 2016年 10月—2018年 1月期间于上海交通大学医学院附属瑞金医院心内科行冷冻球囊导管消融术的老年房颤患者 159例。采用 ZUNG抑郁自评量表（ self-rating depression scale，SDS）及房颤卒中风险评分系统 CHA2DS2-VASc对患者进行调查。术后 3个月，通过门诊及电话方式对患者的主诉、心电图、 24 h动态心电图等进行随访。采用 Logistic回归模型分析患者房颤消融术后复发的独立危险因素。结果 ·成功随访 152例患者，随访完成率为 95.6%。患者平均年龄为（ 61.9±8.9）岁，平均随访时间为（ 8.35±2.41）个月。术后房颤复发 41例，复发率为 27.0%。Logistic回归分析显示，合并症≥ 2种（与合并症 0～ 1种相比）（OR2.466，95% CI为 1.375～ 4.452）、CHA2DS2-VASc评分≥ 2分（OR2.088，95% CI为 1.142～ 5.557）、未规律使用抗心律失常药（ OR1.581，95% CI为 1.351～ 2.125）、高血压（ OR1.317，95% CI为 1.076～ 2.809）和体质量指数（ body mass index，BMI）（OR1.147，95% CI为 1.009～ 1.174）均为术后复发的独立危险因素。结论 ·冷冻球囊导管消融术后患者仍存在一定比例的复发率，合并症≥ 2种、高血压、CHA2DS2-VASc评分≥ 2分、BMI升高以及未规律使用抗心律失常药物是术后房颤复发的潜在危险因素。
关键词: 心房颤动, 老年人, 冷冻球囊导管消融术, 慢性病, 复发
Abstract:
Objective · To evaluate the recurrence rate of atrial fibrillation (Af) and its related risk factors in aged patients with chronic diseases after cryoballoon ablation. Methods · With the method of convenient sampling, a total of 159 patients with Af after cryoballoon ablation were enrolled in the Department of Cardiology, Ruijin Hospital Oct. 2016 to Jan. 2018. Self-rating depression scale (SDS) and CHA2DS2-VASc scores [congestive heart failure, hypertension, age ≥75 y (doubled), diabetes mellitus, stroke(doubled)-vascular disease, age 65-74 and sex category(female)] were used to assess the patients. Follow-up checks consisted of chief complaint, postoperative electrocardiogram (ECG), and 24 h Holter monitoring. Logistic regression models were performed to explore the independent risk factors of Af recurrence after cryoballoon ablation. Results · 152 patients (95.6%) completed the follow-up checks, with an average age of (61.9±8.9) years. The average time of follow-up period was (8.35±2.41) months. A total of 41 patients (27.0%) developed Af after cryoballoon ablation. Logistic regression analysis showed the number of chronic disease ≥2(OR2.466, 95% CI: 1.375-4.452), CHA2DS2-VASc scores ≥ 2(OR2.088, 95% CI: 1.142-5.557), irregular of anti-arrhythmic drugs (OR1.581, 95% CI: 1.351-2.125), hypertension (OR1.317, 95% CI: 1.076-2.809), and body mass index (BMI) (OR1.147, 95% CI: 1.009-1.174) were the independent risk factors of Af recurrence. Conclusion · There is still a certain percentage of recurrence in aged patients with chronic diseases after cryoballoon ablation. 2 and more chronic diseases, irregular of anti-arrhythmic drugs, hypertension, CHA2DS2-VASc scores ≥ 2, and overweight may be potential risk factors of Af recurrence after cryoballoon ablation.
Key words: atrial fibrillation (Af), elderly, cryoballoon ablation, chronic diseases, recurrence
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