非瓣膜病心房颤动转复窦性心律复发影响因素的研究

为探讨非瓣膜病心房颤动(简称房颤)转复窦性心律后的远期复发率及影响因素。选择2000～2002年住院诊断房颤,并进行药物或电转复后成功者,随访1年比较房颤复发与未复发患者的临床特征。进行Logistic回归分析预测房颤复律后复发的独立危险因素。结果:386例房颤患者复律成功,1年后135例复发,复发率为35%,以复律后1周内发生率最高(53%)。复发与未复发组在年龄、复律方法、基础心脏疾病、复律后是否用抗心律失常药物等方面没有显著差异。预测房颤复发的独立危险因素为左房内径≥50mm(OR=1.86),复律前房颤持续≥7天(OR=2.08)和房颤病程≥3个月(OR=1.77)。结论:左房大小和房颤持续时间是房颤复律后复发的重要预测因素。

Predictors in Recurrence of Cardioversion of Atrial Fibrillation With Nonvalvular Disease

The aim of this study is to analysis the relationship of clinical variables to the recurrence of atiral fibrillation after cardioversion to optimize the indication for rhythm control. Retrospective study analysed medical records of the atrial fibrillation patients who have undergone cardioversion from 2000 to 2002. The univariate and multivariate associations of immediate efficacy of cardioversion and long-term results with clinical variables were analyzed. Results: 386 patients who had undergone pharmacological cardioversion or electrical cardioversion were enrolled. Almost half of the patients relapsed within 1 week after successful cardioversion. At the end of one year follow-up, 135 patients (35%) recovered from atrial fibrillation. There were no significant difference between the recurrence group and unrecurrence group in age, heart disease and the methodology of cardioversion. The predictors for the recurrence of atrial fibrillation were diameter of the left atrium ≥50mm(OR=1.86, 95%CI 1.02-3.69, P=0.0472),pre-cardioversion duration ≥7 days (OR=2.08, 95%CI 1.19-3.65, P= 0.01) and the duration of atrial fibrillation (OR=1.77, 95%CI 1.01-3.06, P= 0.0456). Conclusions:The enlargement of left atrium and long duration of atrial fibrillation before cardioversion show less successful rate and more recurrence in the future