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目的探讨Lasso标测导管指导下环肺静脉消融术(CPVA)后心房颤动(简称房颤)早晚期复发的预测因素。方法收集持续性房颤CPVA术后患者的临床及电生理资料结合术后随访,进行多因素相关分析,了解各因素与术后房颤复发的相关性。结果共89例行CPVA术,早期复发房性心律失常29例(32.6%),其中房颤19例(21.3%),晚期共复发房颤29例(32.6%)。多因素回归分析提示最大P波时程(OR1.024,CI1.002～1.046,P=0.03)是房颤早期复发的独立预测因素;而对于房颤晚期复发来说,器质性心脏病(OR4.849,CI1.582～14.866,P=0.006)以及最大P波时程(OR1.048,CI1.017～1.080,P=0.002)是独立预测因素。结论持续性房颤CPVA术后患者,最大P波时程是早晚期复发的独立预测因素,器质性心脏病是晚期复发的独立预测因素。
Objective To investigate the predictive factors of early and late recurrence of atrial fibrillation (PAF) under the guidance of Lasso catheter after circumferential pulmonary vein ablation (CPVA). Methods The clinical and electrophysiological data of patients with persistent atrial fibrillation after CPVA were collected and followed up. Multivariate correlation analysis was performed to find out the correlation between the factors and recurrence of atrial fibrillation. Results A total of 89 patients underwent CPVA surgery and 29 patients (32.6%) had early recurrent atrial arrhythmias, of which 19 (21.3%) had atrial fibrillation and 29 (32.6%) had atrial fibrillation. Multivariate regression analysis showed that the maximal P wave duration (OR1.024, CI 1.002 ~ 1.046, P = 0.03) was an independent predictor of early AF recurrence; whereas for advanced AF recurrence, organic heart disease OR4.849, CI 1.582-14.866, P = 0.006) and the maximum P wave duration (OR1.048, CI1.017 ~ 1.080, P = 0.002) were independent predictors. Conclusion The maximal P wave duration is an independent predictor of early and late recurrence in patients with persistent atrial fibrillation after CPVA. The organic cardiac disease is an independent predictor of late recurrence.