Efficacy of catheter ablation of atrial fibrillation beyond HATCH score
Efficacy of catheter ablation of atrial fibrillation beyond HATCH score
复制标题
导管消融治疗房颤孵化后评分的疗效
DOI：
10.3760/cma.j.issn.0366-6999.2012.19.012
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发表时间：
2012-10-05
影响因子：
6.1
通讯作者：
Ma Chang-sheng
中科院分区：
文献类型：
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作者：
Tang Ri-bo;Dong Jian-zeng;Ma Chang-sheng
背景HATCH评分是阵发性房颤进展为持续性房颤（AF）的既定预测指标。本研究的目的是确定HATCH评分是否可以预测AF导管消融术后复发。方法回顾性分析488例连续阵发性AF患者接受指数环肺静脉（PV）消融术的数据。在这些患者中，250名（51.2%）患者的HATCH评分=0，185（37.9%）患者HATCH评分=1，53（10.9%）患者HATCH评分>= 2（28例患者HATCH评分=2，23例患者HATCH评分=3，结果HATCH评分>= 2分者左房内径明显增大，左室收缩末期内径最大，射血分数最低。平均随访（823 ± 532）d后，HATCH评分=0、HATCH评分=1和HATCH评分≥ 2组的复发率分别为36.4%、37.8%和28.3%（P=0.498）。单变量分析显示，左心房大小、体重指数和肺静脉隔离失败是房颤复发的预测因素。经校正体重指数、左心房大小和肺静脉隔离后，多因素分析显示HATCH评分不是房颤复发的独立预测因子（HR=0.92，95%可信区间=0.76-1.12，P=0.406）。中华医学杂志2012;125（19）：3425-3429
Background HATCH score is an established predictor of progression from paroxysmal to persistent atrial fibrillation (AF). The purpose of this study was to determine if HATCH score could predict recurrence after catheter ablation of AF.Methods The data of 488 consecutive paroxysmal AF patients who underwent an index circumferential pulmonary veins (PV) ablation were retrospectively analyzed. Of these patients, 250 (51.2%) patients had HATCH score=0, 185 (37.9%) patients had HATCH score=1, and 53 (10.9%) patients had HATCH score >= 2 (28 patients had HATCH score=2, 23 patients had HATCH score=3, and 2 patients had HATCH score=4).Results The patients with HATCH score >= 2 had significantly larger left atrium size, the largest left ventricular end systolic diameter, and the lowest ejection fraction. After a mean follow-up of (823 +/- 532) days, the recurrence rates were 36.4%, 37.8% and 28.3% from the HATCH score=0, HATCH score=1 to HATCH score >= 2 categories (P=0.498). Univariate analysis revealed that left atrium size, body mass index, and failure of PV isolation were predictors of AF recurrence. After adjustment for body mass index, left atrial size and PV isolation, the HATCH score was not an independent predictor of recurrence (HR=0.92, 95% confidence interval=0.76-1.12, P=0.406) in multivariate analysis.Conclusion HATCH score has no value in prediction of AF recurrence after catheter ablation. Chin Med J 2012;125(19):3425-3429