QTc interval prolongation predicts the ablation outcome in hypertensive patients with paroxysmal atrial fibrillation
QTc interval prolongation predicts the ablation outcome in hypertensive patients with paroxysmal atrial fibrillation
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QTc 间期延长可预测高血压合并阵发性房颤患者的消融结果
DOI：
10.1093/eurheartj/suv017
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发表时间：
2015
影响因子：
1.6
通讯作者：
Ma Chang-Sheng
中科院分区：
文献类型：
--
作者：
Liu Nian;Wen Song-Nan;Ruan Yan-Fei;Zhang Ting;Li Song-Nan;Wu Jia-Hui;Jiang Chen-Xi;Tang Ri-Bo;Long De-Yong;Bai Rong;Yu Rong-Hui;Du Xin;Dong Jian-Zheng;Ma Chang-Sheng
校正的QT间期异常与房颤的发生有关。目前尚不清楚QTC间期是否是房颤患者射频消融(RFCA)后心律失常复发的标志。本研究旨在探讨QTC间期异常与高血压阵发性房颤患者射频消融术后复发的关系。对242例首次行射频消融术的高血压性阵发性房颤患者进行了回顾分析。收集术前基础数据和QTc值。平均随访17.0±9.4个月，98例房颤复发。复发者QT间期较无复发者延长(429±26vs.419±23ms，P=0.004)。多因素Cox回归分析显示，QTC间期和左房内径是房颤复发的独立预测因素。经多因素调整后，QT间期延长的患者房颤复发的风险增加(危险比2.757，95%可信区间1.661-4.611，P<；0.001)。QTC间期与左前降支联合预测射频消融术后房颤复发的价值增加。左前降支大、QT间期长的患者房颤复发率明显高于左前降支小、QT间期非长的患者(78%vs.27%，P<；0.001)。QTC间期延长是高血压病患者射频消融术后房颤复发的独立危险因素。为判断高血压病患者射频消融术后房颤复发提供了一种简便的预测指标。
An abnormal corrected QT (QTc) interval is associated with the development of atrial fibrillation (AF). It is unclear whether QTc interval is a marker of arrhythmia recurrence after radiofrequency catheter ablation (RFCA) in patients with AF. This study sought to determine the relationship between abnormal QTc interval and the recurrence after RFCA in hypertensive patients with paroxysmal AF. Two hundred and forty-two hypertensive patients with paroxysmal AF who underwent first time RFCA were retrospectively evaluated. Baseline data and QTc before the procedure were collected. Ninety-eight patients had AF recurrence after a mean follow-up of 17.0 ± 9.4 months. Those experiencing recurrence had a longer QTc interval than those without recurrence (429 ± 26 vs. 419 ± 23 ms, P = 0.004). Multivariate Cox regression analysis demonstrated the QTc interval and left atrial diameter (LAD) as independent predictors of AF recurrence. Patients with a long QTc interval were at an increased risk of AF recurrence (hazard ratio 2.757, 95% CI 1.661–4.611, P < 0.001) after adjustment for multiple factors. The QTc interval had an incremental value combined with the LAD in predicting AF recurrence after RFCA. The patients with a large LAD and a long QTc interval had a much higher AF recurrence rate compared with those with a small LAD and a non-long QTc interval (78 vs. 27%, P < 0.001). QTc interval prolongation is an independent risk factor for AF recurrence after RFCA in hypertensive patients. It provides a simple predictor for identifying the patients with hypertension likely to have AF recurrence after RFCA.