论文部分内容阅读
目的:探讨肥胖对于持续性心房颤动(房颤)导管消融治疗的有效性及安全性影响。方法:选择在本中心接受导管消融治疗并能按计划完成随访的持续性房颤患者为研究对象。根据体质指数(BMI)将患者分为正常体重(<24.0kg/m2)、超重(24.0～27.9kg/m2)及肥胖(≥28.0kg/m2)3组。在接受初次导管消融术后,所有患者由固定医生进行随访。通过单变量及多变量回归分析评估肥胖与术后复发间的相关性。结果:342例患者纳入本研究。随访时间为(12.5±9.7)个月,在接受1次消融术后,137例在随访期复发,故本组1次消融成功率为59.9%。根据BMI,分别有109、167、66例属于体重正常、超重、肥胖组。3组间术后复发率差异无统计学意义(P=0.87)。多变量Cox回归分析结果显示左房容积(OR,1.006;95%CI,1.00～1.01;P=0.04)及房颤持续时间(OR,1.06;95%CI,1.03～1.08;P<0.001)是术后复发的独立危险因素。结论:肥胖及超重对于持续性房颤导管消融结果无明显影响。仅有房颤持续时间及左房容积可预测术后复发。
Objective: To investigate the effectiveness and safety of obesity in catheter ablation of persistent atrial fibrillation (AF). METHODS: Patients with persistent AF who underwent catheter ablation and were scheduled to follow-up were enrolled as study subjects. Patients were divided into 3 groups: normal weight (<24.0kg / m2), overweight (24.0 ~ 27.9kg / m2) and obesity (> 28.0kg / m2) according to body mass index (BMI) After receiving the first catheter ablation, all patients were followed up by a fixed physician. Univariate and multivariate regression analyzes were performed to assess the association between obesity and postoperative recurrence. Results: 342 patients were included in this study. The follow-up time was (12.5 ± 9.7) months. After receiving one ablation, 137 patients relapsed during the follow-up period. Therefore, the success rate of one ablation in this group was 59.9%. According to BMI, there were 109,167,66 cases of normal weight, overweight and obesity group. There was no significant difference in the recurrence rate between the three groups (P = 0.87). Multivariate Cox regression analysis showed that left atrial volume (OR, 1.006; 95% CI, 1.00-1.01; P = 0.04) and duration of atrial fibrillation (OR, 1.06; 95% CI, 1.03-1.08; P <0.001) were Postoperative recurrence independent risk factors. Conclusion: Obesity and overweight have no significant effect on catheter ablation of persistent AF. Only the duration of atrial fibrillation and left atrial volume can predict postoperative recurrence.