持续性心房动的废除的特征,趋势和结果:丹麦队列研究
Lise Da Riis-Vestergaard1, Jacob Tønnesen2, Martin H Ruwald1
1Department of Cardiology, Copenhagen University Hospital-Rigshospitalet, Inge Lehmanns Vej 7, 2100 Copenhagen O, Denmark.
European heart journal open
|November 27, 2025
概括
肺静脉隔离加上 (PVI加上) 持续性心房动 (peAF) 的导管切除显示出更高的复发率和随着时间的推移使用的减少. 在PVI和PVI加策略之间,并发症率仍然很低,并且相似.
科学领域:
- 心脏病学 心脏病学
- 电子生理学 电子生理学
- 医疗器械技术 医疗器械技术
背景情况:
- 导管切除 (CA) 是对心房动 (AF) 的标准治疗方法.
- 肺静脉隔离 (PVI) 单独治疗持久性AF (peAF) 的效果不如 Paroxysmal AF (PAF) 的效果.
- 有限的现实世界的数据存在于患者选择,结果和并发症的PVI与PVI加策略在peAF.
研究的目的:
- 检查患者的特征,趋势,复发率和与PVI和PVI加上peAF患者的废除策略相关的并发症.
- 在现实环境中比较PVI和PVI加策略之间的结果.
- 分析使用PVI加上PeAF的策略的时间趋势.
主要方法:
- 丹麦国家废除数据库 (2010-2020年) 的回顾性分析.
- 包括首次进行导管切除的peAF患者.
- 将其分类为PVI或PVI加上移除策略,并评估基线特征,AF复发 (1年和5年),主要心血管不良事件 (MACE) 和并发症.
主要成果:
- 总共分析了4144名peAF患者 (3417名PVI,727名PVI加).
- PVI加组的诊断到切除时间更长,心房扩大更严重.
- 在PVI+组中,AF复发率较高 (54%对1年46%;5年77%对68%),但随着时间的推移,这两组的复发率都下降了.
- 在研究期间,PVI加利用率显著下降,从58%降至15%.
- 这两种策略的MACE和并发症率很低,并且在两种策略之间可以比较.
结论:
- 在peAF患者中,PVI+与较差的结果和随着时间的推移降低的利用率有关.
- 较长的诊断到切除时间和更严重的心房扩大特征是接受PVI加的患者.
- 尽管利用和患者特征存在差异,但PVI和PVI加策略的并发症率相似且低.
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