心房颤动伴心力衰竭患者有无器质性心脏病导管消融的远期预后分析

赵子明; 王瑞敏; 毛幼林; 陈丰毅; 尹晓盟

doi:10.13201/j.issn.1001-1439.2021.09.006

心房颤动伴心力衰竭患者有无器质性心脏病导管消融的远期预后分析

- 1. 南方医科大学附属河南心血管病医院(郑州市心血管病医院)心内科(郑州, 450000);
- 2. 大连医科大学附属第一医院心律失常科
基金项目:
国家自然科学基金面上项目(No:82070346)

河南省医学科技攻关计划项目(No:2018020855)

详细信息

通讯作者: 尹晓盟,E-mail:dr.yinxm@163.com

中图分类号: R541.7

收稿日期: 2021-03-15

The impact of with or without heart disease on long-term outcomes of catheter ablation in patients with atrial fibrillation and systolic dysfunction

- 1. Department of Cardiology, Zhengzhou Cardiovascular Hospital, Zhengzhou, 450000, China;
- 2. The First Affiliated Hospital of Dalian Medical University

More Information

Corresponding author: YIN Xiaomeng, E-mail: dr.yinxm@163.com

Received Date: 15 March 2021

摘要

摘要: 目的:对比心房颤动(房颤)合并心力衰竭(心衰)患者中有无器质性心脏病对于导管消融或者药物治疗下,节律控制的成功率以及远期预后的差异。方法:依据有无器质性心脏病将房颤合并心衰患者分为A组(无器质性心脏病)和B组(有器质性心脏病)。每组进一步细分药物治疗组(A1、B1组)和射频消融组(A2、B2组)。分别比较各组心衰加重住院率和左室射血分数(LVEF)等。结果:A组和B组行射频消融术的患者LVEF的提升优于药物治疗组。A2和B2组因心衰加重住院率(1.1%∶8.7%,P=0.047)、LVEF[(19.9±9.8)%∶(10.1±7.3)%,P<0.001]差异有统计学意义。随访结束时A2组窦性心律维持率明显高于B2组(86%∶62%,P<0.001)。结论:房颤心衰患者导管消融疗效优于药物治疗;无器质性心脏病房颤并心衰的患者行导管消融治疗,获益更明显。
- 心房颤动 /
- 心力衰竭 /
- 导管消融 /
- 有效性
Abstract: Objective: To compare the effection of catheter ablation in patients with coexisting heart failure and atrial fibrillation with and without organic heart disease.Methods: According to the presence or absence of organic heart disease, patients with atrial fibrillation and heart failure were divided into group A(without organic heart disease) and group B(with organic heart disease). Each group was further subdivided into the drug treatment group(A1, B1 group) and the radiofrequency ablation group(A2, B2 group). The hospitalization rate and left ventricular ejection fraction(LVEF) were compared.Results: The improvement of LVEF of patients in group A and group B who underwent radiofrequency ablation was better than that in the drug treatment group. There were statistically significant differences in hospitalization rates(1.1%∶ 8.7%, P=0.047) and LVEF[(19.9±9.8)%∶(10.1±7.3)%, P<0.001]in the A2 and B2 groups due to worsening heart failure. At the end of the follow-up, the maintenance rate of sinus rhythm in group A2 was significantly higher than that in group B2(86%∶ 62%, P<0.001).Conclusion: The effect of catheter ablation in patients with atrial fibrillation and heart failure is better than drug therapy. Patients with atrial fibrillation and heart failure without organic heart disease can benefit more from catheter ablation therapy.
- atrial fibrillation /
- heart failure /
- catheter ablation /
- efficacy

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