局灶性房性心动过速导致心肌病的风险因素研究

Rrisk factors of cardiomyopathy induced by focal atrial tachycardia

摘要:

目的 分析局灶性房性心动过速（ATs）导致心动过速性心肌病（TCM）的发病率、危险因 素及结局。方法 回顾性分析2007 年3 月-2015 年3 月在该院行心内电生理学检查并确诊为局灶性ATs 的196 例患者资料，其中17 例患者确诊为TCM。结果 ①在196 例局灶性ATs 中，TCM 患者多见于年轻 男性（P <0.05）；且心动过速性质多为持续性（P <0.05）；② TCM 患者与局灶性ATs 患者的心动过速周 期、心率比较，差异无统计学意义（P >0.05）；③在多变量分析中，年龄、持续性是TCM 患者的独立危险 因素，且年轻是TCM 患者的显著特征；④（51±19）个月的随访中，16 例TCM 患者经射频消融术或严 格的胺碘酮控制后，左心室射血分数均提高（P <0.05）；1 例TCM 患者因擅自停用胺碘酮死于心力衰竭。 结论 局灶性ATs 导致TCM 的发病率为8.67% ；年轻和持久性是TCM 患者的独立危险因素；大部分 TCM 患者的预后良好。

Abstract:

Objective To investigate the incidence, risk factors and outcome of tachycardia-induced cardiomyopathy (TCM) in patients with focal atrial tachycardia (AT). Methods Formal reports for all patients undergoing electrophysiological studies from March 2007 to March 2015 were included, only 196 patients were diagnosed as focal AT. Of the 196 patients, 17 patients (8.67%) were identified to have TCM. Results The TCM patients were mostly young males (P < 0.05). The TCM was more likely to be persistent (P < 0.05). There was no significant difference in tachycardia cycle length or heart rate between the patients with TCM and those with focal AT (P < 0.05). In a multivariable analysis, the younger age and persistent nature were the independent risk factors for TCM. Only the age was significantly different between the TCM patients and non-TCM patients (P < 0.05). In a (51 ± 19)-month follow-up, 16 TCM patients had improved left ventricle ejection fraction after radiofrequency ablation or strict control with Amiodarone (P < 0.05). However, 1 patient died of heart failure due to unauthorized withdrawal of Amiodarone. Conclusions The incidence of TCM is 8.67% in focal AT patients. Younger age and persistent nature are the independent risk factors for TCM. The prognosis of most TCM patients is good.