CAJ | 학술논문

目的：探讨不同性别的阵发性心房颤动（房颤）患者行导管射频消融有效性与安全性的差异。方法纳入我院自2009年3月~2013年1月阵发性房颤并接受射频消融患者116例，按照患者性别分为男性组（n=71）和女性组（n=45）。随访时间为（6～51）个月，随访期间根据患者症状、心电图及Holter明确房颤是否复发，复发者则再次行消融术治疗，并明确房颤复发原因。比较两组手术成功率及并发症（包括：穿刺部位血肿、心包填塞、脑栓塞、脑出血、肺静脉狭窄及左房食管瘘）发生率，并分析手术复发率与其临床特点[包括：年龄、体质量指数（BMI）、左室射血分值（LVEF）、病史及合并疾病等]的相关性。结果男性组首次手术成功率显著高于女性组（83.1%vs.66.67%，P=0.046）。女性组平均年龄较男性组更高，两组手术并发症无统计学差异。Logistic回归分析女性组复发率高（OR=3.3， P=0.049），复发原因以存在非肺静脉起源驱动灶为主，男性复发还与糖尿病相关（OR=1.99， P=0.037）。结论女性房颤患者接受射频消融治疗更晚，单次治疗成功率较低，但安全性与男性患者无差异。
목적：탐토불동성별적진발성심방전동（방전）환자행도관사빈소융유효성여안전성적차이。방법납입아원자2009년3월~2013년1월진발성방전병접수사빈소융환자116례，안조환자성별분위남성조（n=71）화녀성조（n=45）。수방시간위（6～51）개월，수방기간근거환자증상、심전도급Holter명학방전시부복발，복발자칙재차행소융술치료，병명학방전복발원인。비교량조수술성공솔급병발증（포괄：천자부위혈종、심포전새、뇌전새、뇌출혈、폐정맥협착급좌방식관루）발생솔，병분석수술복발솔여기림상특점[포괄：년령、체질량지수（BMI）、좌실사혈분치（LVEF）、병사급합병질병등]적상관성。결과남성조수차수술성공솔현저고우녀성조（83.1%vs.66.67%，P=0.046）。녀성조평균년령교남성조경고，량조수술병발증무통계학차이。Logistic회귀분석녀성조복발솔고（OR=3.3， P=0.049），복발원인이존재비폐정맥기원구동조위주，남성복발환여당뇨병상관（OR=1.99， P=0.037）。결론녀성방전환자접수사빈소융치료경만，단차치료성공솔교저，단안전성여남성환자무차이。
Objective To investigate the influences of gender on effectiveness and safety of radiofrequency catheter ablation (RFCA) in treatment of atrial fibrillation.Methods The patients (n=116) were chosen from Mar. 2009 to Jan. 2013, and divided into male group (n=71) and female group (n=45). All patients were followed up for (6-51) months, and recrudescence of atrial fibrillation was defined according to symptoms, ECG and Holter during the follow-up. The recrudescence patients were given RFCA once again, and the causes of recrudescence were identified. The success rate of RFCA and incidence of complications (including hematoma at puncture site, pericardial tamponade, cerebral embolism, cerebral hemorrhage, pulmonary vein stenosis and left atrial esophageal fistula) were compared between two groups. The correlation between recurrent rate and clinical features (including age, BMI, LVEF, medical history and complications) was analyzed.Results The success rate of first RFCA was significantly higher in male group than that in female group (83.1%vs. 66.67%,P=0.046). The average age was higher in female group than that in male group. There was no statistical difference in complications between two groups. Logistic regression analysis showed that the recurrent rate was higher in female group (OR=3.3,P=0.049). The cause of recrudescence was mainly non-PV triggers, and furthermore it was related to diabetes in male group (OR=1.99,P=0.037).Conclusion The time of RFCA is later and the success rate of single RFCA is lower in female patients with atrial fibrillation, while there is no difference in safety between female patients and male ones.