二尖瓣L峰对房颤导管消融术后3个月复发的预测作用

目的 通过对房颤射频消融术后3个月复发情况的随访,判断二尖瓣血流图L峰对房颤早期复发的预测价值.方法 选取2015年7月至2016年12月152名在本院就诊并行房颤射频消融术的患者,通过筛选最终入选126名,其中男性71名,女性55名,年龄34 ～ 75岁,平均年龄(57.1±9.0)岁,术前通过超声心动图依照有无二尖瓣血流图L峰分为A、B2组,A组二尖瓣血流图无L峰的患者70人,其中男性40人,女性30人,B组二尖瓣血流图有L峰的患者56人,其中男性31人,女性25人.在房颤射频消融术后3个月随访2组患者的复发情况.结果 A组患者较B组患者有更快的心率、更短的房颤病程和更多的高血压病例数,差异均有统计学意义(分别P＜0.01,P＜0.01和P＜0.05).A组患者随访有13例复发,复发率18.6％,B组患者随访有31例复发,复发率55.4％,2组间复发率差异有统计学意义(P＜0.01),通过单变量统计分析L峰及其他各项可能的影响因素,认为L峰对房颤射频消融术后复发的预测有重要价值(P＜0.01).结论 二尖瓣口血流图L峰可作为房颤射频消融术后3个月复发的预测因子.

Value of mitral L-wave in the prediction of atrial fibrillation after catheter ablation

Objective To find out the value of L-wave in mitral valve blood flow diagram in the prediction of early atrial fibrillation (AF) recurrence through medical follow-up on the recurrence of AF,3 months after catheter ablation.Methods One hundred and fifty-two patients with persistent AF who sought medical care and received catheter ablation in our hospital from July 2015 to December 2016 were selected as research subjects.Following screening,126 patients (71 male and 55 female) with an age of (34-75 years old) and average age of (57.1-± 9.0)were included in the study.The patients were divided into 2 groups (group A and group B) by depending upon whether or not they had L-wave in the mitral valve blood flow diagram by echocardiography before ablation.Recurrence of AF was tracked by the way of medical follow-ups 3 months after catheter ablation.Results There were 70 patients (40 male,30 female) in group A that did not have L-wave in the mitral valve blood flow diagram,while in group B there were 56 patients (31 male,25 female) that displayed L-wave in the diagram.The patients in group A had higher mean heart rate,shorter duration of AF and more cases of hypertension,as com pared with the patients in group B,with statistical significance (P ＜0.01,P ＜ 0.01,P ＜ 0.05).Medical follow-ups indicated that 13 patients in group A had AF recurrence,accounting for 18.6％,while 31 patients in group B had AF recurrence,accounting for 55.4％.There was statistical significance in recurrence rate,when comparisons were made between the 2 groups(P ＜0.01).Univariate analysis of L-wave and other possible influential factors showed that L-wave might be an indicator of important value for the prediction of AF recurrence after catheter ablation (P ＜ 0.01).Conclusion L-wave in the mitral valve blood flow diagram might be an important indicator for the prediction of AF recurrence,3 months after catheter ablation.