重新考虑在心房移除之后适当的空白期
Naoaki Onishi1, Akihira Suenaga1, Akinori Yoshida1
1Division of Cardiology, Japanese Red Cross Otsu Hospital, 1-1-35, Nagara, Otsu, Shiga, 520-8511, Japan.
概括
导管切除 (CA) 后心房 (AF) 的早期复发强烈预测晚期复发. 30天的空白期可能足以评估CA后的复发,特别是在重复程序后.
科学领域:
- 心脏病学 心脏病学
- 电子生理学 电子生理学
- 医疗器械 医疗器械
背景情况:
- 对于心房动 (AF) 的导管切除 (CA) 后的早期复发 (ER) 与晚期复发 (LR) 有关.
- 在重复CA程序中,关于ER和LR的数据有限.
- 讨论了评估CA后复发的最佳空白期 (BP),并建议将其从90天缩短到30天.
研究的目的:
- 在AF的第一个和第二个CA程序中调查ER和LR之间的关联.
- 与传统的90天BP相比,评估30天BP在预测LR方面的有效性.
主要方法:
- 对511名患者进行首次CA和116名患者进行AF第二次CA的回顾性分析.
- 患者根据BP (0-30天和31-90天) 内的最后一次ER事件的时间对患者进行了分类.
- 对LR的危险比率与没有ER的患者相比计算.
主要成果:
- 在90天内ER显著增加了在第一和第二CA程序中的LR风险.
- 当最后一次ER事件发生在CA后31-90天之间时,LR的风险显著增加 (第一个CA的HR9.7,第二个CA的HR44.1).
- 这种关联在第二次CA程序后特别明显.
结论:
- 在AF的CA之后,ER是LR的强有力的预测因素.
- 较短的30天BP可能足以预测LR,特别是考虑到肺静脉隔离 (PVI) 耐久性的改善.
- 这些发现特别适用于第二次CA程序,其中PVI预计将更持久.
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