Risk factors for adverse outcomes in atrial fibrillation patients undergoing radiofrequency ablation:a prospective cohort study
10.3969/j.issn.1004-8812.2025.03.001
- VernacularTitle:一项前瞻性队列研究:心房颤动射频消融治疗术后出现不良结局的风险因素
- Author:
Jin BAI
1
;
Peng-xin XIE
;
Yan-guang LI
;
Ran JING
;
Zong-shi LI
;
Gong-bu ZHOU
;
Shu-wang LIU
Author Information
1. 北京大学第三医院心内科 血管医学研究所 血管稳态与重构全国重点实验室,北京 100191
- Publication Type:Journal Article
- Keywords:
Atrial fibrillation;
Major adverse cardiovascular events;
Radiofrequency ablation;
Age;
Hypertrophic cardiomyopathy
- From:
Chinese Journal of Interventional Cardiology
2025;33(3):121-127
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the factors that influence major adverse cardiovascular events(MACE)in atrial fibrillation(AF)patients undergoing radiofrequency ablation(RFA),as well as to compare the prognosis of patients with advanced AF to that of the general population.Methods We prospectively recruited AF patients who underwent RFA treatment at Peking University Third Hospital between January 2021 and March 2023.General patient data were collected through the hospital's inpatient system,and MACE were tracked through outpatient visits and telephone follow-ups.Patients were categorized into three age groups:Group 1(under 65 years),Group 2(65 to 75 years),and Group 3(over 75 years).In this study,MACE was defined as include cardiovascular death,all-cause death,readmission for heart failure,acute coronary syndrome(ACS),grade 2 or higher bleeding and stroke.Results A total of 431 patients were included in this study,with an average age of(66.17±12.22)years.Among these patients,259 were male(60.09％),and the mean of CHA2DS2-VASc score was(1.79±1.30).The median follow-up period was 16.0(11.3,21.3)months,during which 28(6.50％)patients experienced MACE,with ACS and stroke being the most common events.Variables were selected using LASSO regression,and a LASSO-Cox regression model was constructed.Age(HR 1.06,95％CI 1.02-1.10,P=0.006)and hypertrophic cardiomyopathy(HR 3.70,95％CI 1.27-8.68,P=0.008)were identified as independent predictors of MACE after RFA for AF.Subgroup analysis revealed that patients under 65 had significantly better prognoses compared to older AF patients(P=0.030 compared with group 2;P=0.021 compared with group 3).Conclusions Age and hypertrophic cardiomyopathy are independent risk factors for MACE in AF patients undergoing RFA.The prognosis for younger patients is better than that for older patients,while the prognosis for advanced patients is comparable to that of patients aged 65-75 years.
