Changes in Cardiac Function and Prediction of Late Recurrence Risk Factors in Atrial Fibrillation Patients undergoing One-stop Procedure
10.11969/j.issn.1673-548X.2025.10.014
- VernacularTitle:一站式术后心房颤动患者心功能变化及晚期复发危险因素的预测
- Author:
Zhiqing JIA
1
;
Wangliang ZHU
;
Mingzhe SONG
Author Information
1. 010017 呼和浩特,内蒙古医科大学内蒙古临床医学院
- Publication Type:Journal Article
- Keywords:
Atrial fibrillation;
One-stop procedure;
Cardiac function;
Recurrence;
Risk factors
- From:
Journal of Medical Research
2025;54(10):79-83,88
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the impact of catheter ablation(CA)combined with left atrial appendage closure(one-stop procedure)on cardiac function in atrial fibrillation(AF)patients,and analyze the risk factors for late AF recurrence after one-stop pro-cedure.Methods A total of 225 patients who visited the Inner Mongolia Autonomous Region People's Hospital for AF from January 2020 to December 2023 were included,and they were divided into the one-stop procedure group(n=93)and the CA group(n=132)ac-cording to the procedure,and 55 patients with matching clinical baseline characteristics were respectively screened out at a ratio of 1:1 by the method of propensity score matching,namely the CA group(n=55)and the one-stop procedure group(n=55),and the changes in cardiac function between the two groups were compared between preoperative and 1-year postoperative periods.Risk factors for late post-operative recurrence of AF and their predictive value in the one-stop procedure group were assessed using multivariate Logistic regression analysis and receiver operating characteristic(ROC)curve.Results At 1 year postoperatively,N-terminal B-type natriuretic peptide(NT-proBNP),left atrial internal diameter(LAD),and left ventricular end-diastolic diameter(LVEDD)were significantly lower and left ventricular ejection fraction(LVEF)was significantly higher in both groups compared with the preoperative period(P＜0.05),but there was no statistically significant difference in the improvement degree of cardiac function between the two groups at 1 year postopera-tively(P＞0.05).The results of the univariate analysis showed that there were statistically significant differences in NT-proBNP,LAD,and left ventricular end-systolic diameter(LVESD)in the one-stop procedure late postoperative recurrence group compared with late postoperative non-recurrence group(P＜0.05),and the results of multivariate Logistic regression analysis showed that the preoperative NT-proBNP(OR=1.075,95％CI:1.029-1.124,P=0.001)and preoperative LAD(OR=1.222,95％CI:1.094-1.365,P＜0.001)were the risk factors for late recurrence of AF after one-stop procedure.The results of the ROC curve analysis showed that the area under the curve(AUC)of NT-proBNP,LAD,and the combination of the two in predicting late recurrence of AF after one-stop procedure were 0.788,0.772 and 0.846,respectively,with a sensitivity of 84.4％,68.8％and 87.5％,and a specificity of 68.9％,78.7％and 77.0％,respectively.Conclusion Both one-stop procedure and CA can significantly improved cardiac function in patients with AF with comparable results.Preoperative LAD enlargement and NT-proBNP elevation are independent risk factors for late recur-rence of AF after one-stop procedure,and the combination of the two can effectively improve the efficacy of AF recurrence risk assess-ment.
