Impact of the origin of sinus node artery on recurrence after pulmonary vein isolation in patients with paroxysmal atrial fibrillation

被引：6

作者：

Zhang Zhi-jun ^{[1
,2
]}

Chen Ke ^{[1
,2
]}

Tang Ri-bo ^{[1
,2
]}

Sang Cai-hua ^{[1
,2
]}

Lao, Edmundo Patricio Lopes ^{[1
,2
]}

Yan Qian ^{[1
,2
]}

He Xiao-nan

Du Xin ^{[1
,2
]}

Long De-yong ^{[1
,2
]}

Yu Rong-hui ^{[1
,2
]}

Dong Jian-zeng ^{[1
,2
]}

Ma Chang-sheng ^{[1
,2
]}

机构：

[1] Capital Med Univ, Beijing Anzhen Hosp, Ctr Atrial Fibrillat, Dept Cardiol, Beijing 100029, Peoples R China

[2] Beijing Inst Heart Lung & Blood Vessel Dis, Beijing 100029, Peoples R China

来源：

CHINESE MEDICAL JOURNAL | 2013年 / 126卷 / 09期

基金：

美国国家科学基金会; 北京市自然科学基金;

关键词：

atrial fibrillation; catheter ablation; coronary angiography; recurrence; sinus node artery; CATHETER ABLATION; EUROPEAN-SOCIETY; OF-CARDIOLOGY; RECOMMENDATIONS; ASSOCIATION; PREVALENCE; MANAGEMENT; LESIONS; BRANCH; SITES;

D O I：

10.3760/cma.j.issn.0366-6999.20123413

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background Major atrial coronary arteries, including the sinus node artery (SNA), were commonly found in the areas involved in atrial fibrillation (AF) ablation and could cause difficulties in achieving linear block at the left atrial (LA) roof. The SNA is a major atrial coronary artery of the atrial coronary circulation. This study aimed to determine impact of the origin of SNA on recurrence of AF after pulmonary vein isolation (PVI) in patients with paroxysmal AF. Methods Seventy-eight patients underwent coronary angiography for suspected coronary heart disease, followed by catheter ablation for paroxysmal AF. According to the origin of SNA from angiographic findings, they were divided into right SNA group (SNA originating from the right coronary artery) and left SNA group (SNA originating from the left circumflex artery). Guided by an electroanatomic mapping system, circumferential pulmonary vein ablation (CPVA) was performed in both groups and PVI was the procedural endpoint. All patients were followed up at 1, 3, 6, 9 and 12 months post-ablation. Recurrence was defined as any episode of atrial tachyarrhythmias (ATAs), including AF, atrial flutter or atrial tachycardia, that lasted longer than 30 seconds after a blanking period of 3 months. Results The SNA originated from the right coronary artery in 34 patients (43.6%) and the left circumflex artery in 44 patients (56.4%). Freedom from AF and antiarrhythmic drugs (AADs) at 1 year was 67.9 % (53/78) for all patients. After 1 year follow-up, 79.4% (27/34) in right SNA group and 59.1% (26/44) in left SNA group (P=0.042) were in sinus rhythm. On multivariate analysis, left atrium size (HR=1.451, 95% CI: 1.240-1.697, P <0.001) and a left SNA (HR=6.22, 95% CI: 2.01-19.25, P=0.002) were the independent predictors of AF recurrence. Conclusions The left SNA is more frequent in the patients with paroxysmal AF. After one year follow-up, the presence of a left SNA was identified as an independent predictor of AF recurrence after CPVA in paroxysmal AF.

引用

页码：1624 / 1629

页数：6

共 29 条

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