左房容积与心房颤动导管消融术后患者复发的关系

目的探讨左房容积(LAV)与心房颤动(简称房颤)消融术后房颤复发的相关性。方法 104例房颤患者。术前应用64排容积CT扫描,在advantage workstation4.2图像工作站中重建左房,测量LAV,术中通过三维标测系统(CARTO)指导行射频消融术,术后3个月评定治疗效果,并随访6个月。结果随访6个月结束,104例中有20例(19%)房颤复发。单因素分析结果显示,复发组平均LAV比未复发组的大[117.6±28.9cm3,95%可信区间(CI)104.1~131.1cm3vs97.1±16.8cm3,95%CI93.5~100.8cm3,P=0.006]。多因素分析显示LAV是独立的预测导管消融术后复发的指标(P(0.05,相对风险度=1.044,95%CI1.018~1.071)。结论房颤射频消融术后房颤复发与LAV大小相关。

Relationship between left atrial volume calculated by multi-detector computed tomography and the atrial fibrillation recurrence after catheter ablation

Objective To investigate whether left atrial volume （LAV）, evaluated by muhi-detector computed tomography（MDCT） prior to ablation, will predict atrial fibrillation（AF） recurrence following catheter ablation. Methods One hundred and four patients （mean age 56.8 -8.9 years,67% male） with symptomatic AF were studied. All patients were submitted to 64-slice MDCT scan for LAV. The success of pulmonary vein isolation procedure was guided by CARTO Merge electroanatomical mapping. All patients were followed up in out-patient clinic for six months. Clinical success was assessed after 3-month blanking period. Results At the end of follow-up period, 20 patients（ 19% ） suffered from recurrent AF. Univariate analysis showed that the mean LAV of the recurrent group of patients was bigger than that of the non-recurrent group of patients（ 117.6 ±28.9 cm3 95% CI 104.1 - 131, 1 cm3 vs 97.1 ± 16.8 cm3 ,95% CI 93.5 - 100.8 cm3 ,P = 0.006 ）. Muhivariable analysis revealed that LAV was an independent risk factor responsible for the recurrence of AF （RR=1.044,95% CI1.018-1.071,P=0.017）. Conclusion LAV estimated by MDCT is an independent predictor of AF recurrence after catheter ablation.