QTc interval predicts outcome of catheter ablation in paroxysmal atrial fibrillation patients with type 2 diabetes mellitus
QTc interval predicts outcome of catheter ablation in paroxysmal atrial fibrillation patients with type 2 diabetes mellitus
复制标题
QTc 间期预测 2 型糖尿病阵发性房颤患者导管消融的结果
DOI：
10.1007/s11596-016-1640-5
复制
发表时间：
2016
影响因子：
--
通讯作者：
Dong JZ
中科院分区：
文献类型：
--
作者：
Ma Ning;Wu Xiao-yan;Ma Chang-sheng;Liu Nian;Bai Rong;Du Xin;Ruan Yan-fei;Dong Jian-zeng;Dong JZ
导管消融已被推荐作为阵发性心房颤动（PAF）合并 2 型糖尿病（T2DM）患者的治疗选择。 PAF合并T2DM患者导管消融后复发率较高。校正 QT (QTc) 间期延长与 T2DM 患者的不良预后有关。异常 QTc 间期是否与 PAF 合并 T2DM 患者的消融结果相关仍不清楚。在这项研究中，回顾性纳入了 134 例接受初级导管消融术的患有 T2DM 的 PAF 患者。使用 Bazett 公式校正术前 QTc 间期。构建 Cox 比例风险模型来评估 QTc 间期与 AF 复发之间的关系。经过 29.1 个月的随访，61 名患者出现房性快速心律失常复发。复发患者的QTc间期长于非复发患者（425.2±21.5 ms vs. 414.1±13.4 ms，P=0.002）。多变量Cox回归分析显示，QTc间期[风险比（HR）=1.026，95%置信区间（CI）1.012-1.040，P=0.005]和左心房直径（LAD）（HR=1.125，95% CI 1.062-1.192，P=0.003）是房性复发的独立预测因素。 快速心律失常。受试者操作特征分析表明，QTc 截止值（418 ms）预测心律失常复发的敏感性为 55.7%，特异性为 69.9%。 LAD 和 QTc 组合在预测术后心律失常复发方面比单独使用 LAD 更有效 (P<0.001)。 QTc 间期可用作接受 AF 消融的 T2DM 患者心律失常复发的独立预测因子，从而提供一种简单的方法来识别手术后可能有更好结果的患者。
Catheter ablation has been recommended as a treatment option for paroxysmal atrial fibrillation (PAF) patients complicated with type 2 diabetes mellitus (T2DM). PAF patients with T2DM have a higher recurrence rate after catheter ablation. Prolongation of corrected QT (QTc) interval has been linked to poor outcomes in T2DM patients. Whether the abnormal QTc interval is associated with the ablation outcome in the PAF patients with T2DM remains unknown. In this study, 134 PAF patients with T2DM undergoing primary catheter ablation were retrospectively enrolled. Pre-procedural QTc interval was corrected by using the Bazett’s formula. Cox proportional hazards models were constructed to assess the relationship between QTc interval and the recurrence of AF. After a 29.1-month follow-up period, 61 patients experienced atrial tachyarrhythmia recurrence. Recurrent patients had a longer QTc interval than non-recurrent patients (425.2±21.5 ms vs. 414.1±13.4 ms,P=0.002). Multivariate Cox regression analysis revealed that QTc interval [hazard ratio (HR)=1.026, 95% confidence interval (CI) 1.012–1.040,P=0.005] and left atrial diameter (LAD) (HR=1.125, 95% CI 1.062–1.192,P=0.003) were independent predictors of recurrent atrial tachyarrhythmia. Receiver operating characteristic analysis demonstrated that the cut-off value of QTc (418 ms) predicted arrhythmia recurrence with a sensitivity of 55.7% and a specificity of 69.9%. A combination of LAD and QTc was more effective than LAD alone (P<0.001) in predicting arrhythmia recurrence after the procedure. QTc interval could be used as an independent predictor of arrhythmia recurrence in T2DM patients undergoing AF ablation, thus providing a simple method to identify those patients who likely have a better outcome following the procedure.