Influencing factors of prognosis of patients with atrial fibrillation and heart failure after rhythm con-trol therapy
10.3969/j.issn.1008-0074.2023.06.01
- VernacularTitle:房颤合并心衰患者节律控制治疗预后的影响因素
- Author:
Zhi-Cheng FAN
1
;
Lei LIU
;
Wan-Lin ZHAN
;
Qing-Yong ZHANG
;
Ting SUN
Author Information
1. 上海交通大学医学院附属第九人民医院心血管内科,上海市 200011
- Keywords:
Heart failure;
Atrial fibrillation;
Catheter ablation
- From:
Chinese Journal of cardiovascular Rehabilitation Medicine
2023;32(6):549-554
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To study influencing factors of prognosis of patients with atrial fibrillation(AF)and heart fail-ure(HF)after rhythm control therapy.Methods:According to rhythm control methods,a total of 379 AF+HF patients treated in our hospital were divided into medication group(n=133)and surgery group(n=246,received catheter ablation of AF);according to AF type,patients were divided into paroxysmal AF group(n=208)and per-sistent AF group(n=171),and general clinical data and rhythm control effect were compared among all groups.According to NYHA cardiac function classification,patients were divided into NYHA classⅡ group(n=160),classⅢ group(n=188)and class Ⅳ group(n=31),and rhythm control effect was compared among above groups.Re-sults:Compared with medication,there were significant reductions in percentage of AF recurrence and LAD after treatment,and significant rise in percentage of heart function improvement in paroxysmal AF group,persistent AF group,NYHA class Ⅱ and Ⅲ group in those underwent surgery(P＜0.05 or＜0.01).Multivariate Logistic re-gression analysis indicated that medication,persistent AF were independent risk factors for AF recurrence and no cardiac function improvement after rhythm control therapy(OR=2.426～7.908,P=0.001 all),and NYHA classⅡ was an independent protective factor for AF recurrence after rhythm control therapy(OR=0.393,P=0.049).Conclusion:Atrial fibrillation catheter ablation can significantly improve prognosis of AF+HF patients.Persistent AF and antiarrhythmic medication are independent risk factors for poor prognosis after rhythm control therapy.
