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Risk factors of recurrent atrial fibrillation after radiofrequency catheter ablation
- CHEN Linlin, YI Shaolei, WANG Weizong, LI Zhan, ZHANG Yong, ZHANG Yujiao,REN Manyi, XIE Xinxing, LIU Tongbao, HOU Yinglong
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Journal of Shandong University (Health Sciences). 2019, 57(3):
49-57.
doi:10.6040/j.issn.1671-7554.0.2018.179
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Objective To evaluate recurrence-related risk factors of atrial fibrillation(AF)after radiofrequency catheter 山 东 大 学 学 报 (医 学 版)57卷3期 -陈琳琳,等.预测心房颤动患者射频消融术后复发的危险因素 \=-ablation(RFCA). Methods A total of 270 patients who underwent RFCA were enrolled as the AF group, and 100 healthy subjects as the control group. Clinical baseline information and peripheral venous blood of the two groups were collected. Biochemical markers and miRNA expressions were detected. During the follow-up of 12 months, the patients were divided into the recurrence group and non-recurrence group, and further divided into paroxysmal AF and persistent AF subgroups. Univariate analysis and Logistic regression analysis were used to screen out relevant hazards after RFCA. The area under the receiver operating characteristic(ROC)curve(AUC)in the AF subgroups was analyzed to judge the accuracy of predictive factors. Results The univariate analysis showed statistical differences in the expressions of miRNA-21, miRNA-133, miRNA-150, miRNA-206 and miRNA-328 between the control group and AF group(P<0.05), and statistical differences in the AF type, electric conversion, duration of disease, CHADS2 scoring, left atrial diameter(LAD), left ventricular ejection fraction(LVEF), uric acid and miRNA-21 expression between the recurrence group and non-recurrence group(P<0.05). Logistic regression analysis revealed that LAD(OR=1.187, P=0.031)and miRNA-21 expression(OR=1.226, P=0.012)in the paroxysmal AF subgroup had statistical significance. LAD(OR=1.125, P=0.035), course of disease(OR=1.023, P=0.019), and miRNA-21 expression(OR=1.177, P=0.032)in the persistent AF subgroup had statistical significance. In the paroxysmal AF subgroup, LAD was used as the index to calculate AUC, and the result was 0.750. When miRNA-21 expression and LAD together served as the comprehensive index, AUC=0.844 was derived. AUC measured by the combination of LAD, course of disease and miRNA-21 expression in the persistent AF group also had reference value. Conclusion LAD and miRNA-21 expression are independent recurrence-related risk factors after RFCA in patients with paroxysmal AF, while LAD, miRNA-21 expression and duration of disease are independent recurrence-related risk factors for persistent AF.
