诊断到消除时间对AF复发的影响:在前3年内明显,之后无关紧要
Yves De Greef1, Kris Bogaerts2, Dimitrios Sofianos3
1Department of Cardiology, ZNA Heart Centre, Antwerp, Belgium; Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, Universitair Ziekenhuis Brussel-Vrije Universiteit Brussel, European Reference Networks Guard-Heart, Brussels, Belgium.
JACC. Clinical electrophysiology
|September 1, 2023
概括
在肺静脉隔离 (PVI) 后,较短的诊断至切除时间 (DAT) 更好地预防心房动 (AF) 复发. 经过36个月后,很少看到益处,特别是在持续性AF.
科学领域:
- 心脏病学 心脏病学
- 电力生理学 电力生理学
- 医疗信息学 医疗信息学
背景情况:
- 诊断到切除时间 (DAT) 是已知的心房动 (AF) 复发切除后的预测指标.
- 预测AF复发的最佳DAT值仍然没有定义.
研究的目的:
- 调查DAT对AF复发的影响.
- 为了确定与肺静脉隔离 (PVI) 后AF复发相关的潜在的下部和上部DAT值.
主要方法:
- 在两个队列 (2005-2014年和2017-2019年) 中分析了2000名接受PVI的AF患者.
- 随访持续时间为PVI后3年.
- 多变量考克斯比例危险模型,以评估与DAT相关的AF复发.
主要成果:
- 临床成功率为61.7%.
- 群体间的DAT中位数从36个月大幅下降到12个月.
- 在前36个月内,AF复发急剧增加 (27%至40%),直到90个月 (至45%) 的缓慢增长,然后趋于平稳.
- 在持续性AF中观察到更高的复发率,相比于在前36个月内发生的阳性AF.
结论:
- 没有确定DAT的下限;较短的时间与更好的结果有关.
- 对AF复发的有限临床益处在诊断后36个月后被观察到.
- 建议在AF诊断后3年内进行PVI,特别是在持续的AF病例中.
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