Risk of Stroke and Recurrence After AF Ablation in Patients With an Initial Event-Free Period of 12 Months
Risk of Stroke and Recurrence After AF Ablation in Patients With an Initial Event-Free Period of 12 Months
复制标题
DOI：
10.1111/jce.13138
复制
发表时间：
2017-03-01
影响因子：
2.7
通讯作者：
Verma, Atul
中科院分区：
文献类型：
--
作者：
Kochhauser, Simon;Alipour, Pouria;Verma, Atul
房颤消融后的中风和复发简介由于心房颤动（AF）消融的预后效果尚不清楚，因此即使在无症状患者中，消融后通常仍继续口服抗凝药（OAC）。我们试图确定成功进行 AF 消融后 1 年内接受和停止治疗 OAC 的患者中风和 AF 复发的频率。方法和结果从我们的 AF 数据库中选择接受 AF 消融且消融后 12 个月没有 AF 的患者。在随访 (FU) 期间，对患者进行 AF 复发、OAC 或抗心律失常药物变化以及中风或短暂性脑缺血发作 (TIA) 发生情况的筛查。共有 398 名患者（中位年龄 60.7 岁 [50.8, 66.8]，25% 女性）接受了调查。 FU 的中位持续时间为 529 (373, 111,3.5) 天。 276 名患者 (69.3%) 停用了 OAC。在 FU 期间，4 名患者（1%）出现中风，55 名患者（13.8%）出现 AF 复发。持续性 AF 与 AF 复发几率较高显着相关（49.1% vs. 26.8%；P = 0.001）。在患有或不患有卒中的患者中，CHADS(2)、CHA2DS2-VASc-Score 和 AF 复发均无显着差异。经历过中风的患者中，冠状动脉疾病的比例有较高的趋势（50% vs. 10%；P = 0.057）。 结论 AF 消融后无复发间隔至少 12 个月的患者中风和 AF 复发的总体风险较低。值得注意的是，在我们的研究人群中，房颤复发与中风风险较高无关。
Stroke and Recurrence After AF AblationIntroductionBecause of the unclear prognostic effects of ablation of atrial fibrillation (AF), oral anticoagulation (OAC) is often continued after ablation even in asymptomatic patients. We sought to determine the frequency of stroke and AF recurrence in patients on and off therapeutic OAC 1 year after a successful AF ablation.Methods and ResultsPatients that underwent AF ablation and were free of AF 12 months after ablation were selected from our AF database. During follow-up (FU), patients were screened for recurrence of AF, changes in OAC or antiarrhythmic medication, and the occurrence of stroke or transient ischemic attack (TIA). A total of 398 patients (median age 60.7 years [50.8, 66.8], 25% female) were investigated. The median duration of FU was 529 (373, 111,3.5) days. OAC was discontinued in 276 patients (69.3%). During FU, 4 patients (1%) suffered from stroke and 55 patients (13.8%) experienced a recurrence of AF. Persistent AF was significantly associated with a greater chance of AF recurrence (49.1% vs. 26.8%; P = 0.001). Neither CHADS(2) nor CHA2DS2-VASc-Score nor recurrence of AF were significantly different in patients with or without stroke. There was a trend toward a higher percentage of coronary artery disease among patients that experienced stroke (50% vs. 10%; P = 0.057).ConclusionThe overall risk of stroke and AF recurrence is low in patients with a recurrence free interval of at least 12 months after AF ablation. Of note, recurrence of AF was not associated with a higher risk of stroke in our study population.