Analysis of predictive factors for late recurrence of atrial fibrillation after surgical ablation in patients undergoing rheumatic valve surgery.

IF 2.6 3区医学 Q2 RESPIRATORY SYSTEM

BMC Pulmonary Medicine Pub Date : 2024-09-20 DOI:10.1186/s12890-024-03231-2

Qingsong Wu, Huangwei Li, Linfeng Xie, Xinfan Lin, Zhihuang Qiu, Liangwan Chen

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引用次数: 0

Abstract

Objectives: To identify independent predictors of late recurrence of atrial fibrillation (AF) after surgical ablation in patients undergoing rheumatic valve surgery.

Methods: A total of 258 patients who underwent surgical ablation for AF with rheumatic heart disease at our hospital between January 2019 and June 2022 were retrospectively included. The patients were followed up for 12 months. Late recurrence was defined as any AF recurrence longer than 30 s between 3 and 12 months. Patients with or without late recurrence were divided into non-recurrence and recurrence groups. Univariate and multivariate analyses were performed to identify the predictors of late recurrence.

Results: The in-hospital mortality rate was 0.8% (2/258), and the late recurrence rate of AF was 38.4%, including 152 and 95 cases in the non-recurrent and recurrent groups respectively, with a follow-up completion rate of 96.5% (247/256). There were no deaths during follow-up, two patients (0.8%) experienced a stroke, and one patient (0.4%) experienced gastrointestinal hemorrhage. The results of the univariate and multivariate analyses of the preoperative risk factors for late recurrence showed a left atrial (LA) anteroposterior diameter ≥ 52.9 mm (odds ratio [OR] = 2.366, 95% confidence interval [CI] = 1.089-5.138, P = 0.030], ratio of the superoinferior to the anteroposterior diameters of LA (S-AR) < 1.19 (OR = 4.639, 95% CI = 2.181-9.865, P < 0.001), and AF duration ≥ 39 months (OR = 6.152, 95% CI = 2.897-13.061, P < 0.001), and cardiothoracic ratio ≥ 0.63 (OR = 2.716, 95% CI = 1.314-5.612, P = 0.007) were the most significant independent risk factors.

Conclusions: LA anteroposterior diameter ≥ 52.9 mm, S-AR < 1.19, and AF duration ≥ 36 months and cardiothoracic ratio ≥ 0.63 are independent predictors for late recurrence of AF after surgical ablation in patients undergoing rheumatic valve surgery.

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风湿性瓣膜手术患者手术消融后心房颤动晚期复发的预测因素分析。

目的：确定风湿性瓣膜手术患者手术消融后房颤晚期复发的独立预测因素：确定风湿性瓣膜手术患者手术消融后房颤晚期复发的独立预测因素：回顾性纳入2019年1月至2022年6月期间在我院接受风湿性心脏病房颤手术消融的258例患者。对患者进行了 12 个月的随访。晚期复发的定义是在 3 至 12 个月期间房颤复发时间超过 30 秒。有或没有晚期复发的患者被分为未复发组和复发组。进行单变量和多变量分析以确定晚期复发的预测因素：院内死亡率为 0.8%（2/258），房颤晚期复发率为 38.4%，其中非复发组和复发组分别为 152 例和 95 例，随访完成率为 96.5%（247/256）。随访期间无死亡病例，两名患者（0.8%）中风，一名患者（0.4%）消化道出血。术前晚期复发风险因素的单变量和多变量分析结果显示，左心房（LA）前胸直径≥52.9 mm（比值比[OR]=2.366，95% 置信区间[CI]=1.089-5.138，P=0.030]，LA前胸直径与左心房前胸直径的比值（S-AR）结论：左心房前胸直径≥52.9 mm（比值比[OR]=2.366，95% 置信区间[CI]=1.089-5.138，P=0.030）会导致晚期复发：LA 前胸直径≥ 52.9 mm，S-AR

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来源期刊

BMC Pulmonary Medicine RESPIRATORY SYSTEM-

CiteScore

4.40

自引率

3.20%

发文量

423

审稿时长

6-12 weeks

期刊介绍： BMC Pulmonary Medicine is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of pulmonary and associated disorders, as well as related molecular genetics, pathophysiology, and epidemiology.