摘要
Abstract
Objective To investigate the incidence of acute ischemic stroke in patients with atrial fibrilation after radio frequency catheter ablation(RFCA)and to explore the influencing factors. Methods A retrospective analysis was performed on 4 573 inpatients who were diagnosed as paroxysmal or consistent atrial fibrillation and received RFCA in the Department of Cardiovascular Medicine of Beijing Anzhen Hospital,Capital Medical University from January 2012 to December 2015. According to whether acute ischemic stroke occurred during hospitalization after RFCA,we divided the patients into stroke group and control group. We recorded gender,age,medical history and complications,atrial fibrilation type,times of surgery,hospitalization time,case fatality rate in the hospital,and ADL score at admission and discharge. Results Among the 4 573 patients,22 patients had acute ischemic stroke(stroke group)with an incidence of 0. 48% ,19(0. 41% )patients had cerebral infarction, and 3(0. 07% )patients had transient ischemic attack(TIA). The rest 4 551 patients who had no acute ischemic stroke were enrolled as control group. Control group and stroke group were not significantly different in gender,age and the incidence rates of previous hypertension,diabetes,hyperlipemia,coronary heart disease,valvular heart disease and the times of surgery( P >0. 05);control group and stroke group were significantly different in the incidence rates of previous ischemic cerelral infarction and cardiac insufficiency,and atrial fibrillation type(P < 0. 05). Multivariate Logistic regression analysis showed that previous acute ischemic stroke〔 OR = 21. 342,95% CI(6. 549,69. 546)〕,insufficient cardiac function〔 OR = 8. 782,95% CI (3. 173,24. 308)〕and consistent atrial fibrillation〔 OR = 2. 990,95% CI(1. 137,7. 860)〕were independent risk factors for acute ischemic stroke in atrial fibrillation patients after RFCA during hospitalization( P < 0. 05). Compared with control group,stroke group had longer hospitalization time〔13(24) d vs. 5(2) d〕,higher case fatality rate〔9. 09% (2 / 22) vs. 0. 13% (6 / 4 551)〕,and lower ADL score at discharge〔(89. 8 ± 14. 6) vs. (99. 1 ± 4. 1)〕than control group(P <0. 05). Conclusion The overall incidence of acute ischemic stroke of patients with atrial fibrillation after RFCA is low,while acute ischemic stroke lengthens hospitalization time,increases case fatality rate in hospitals,and influences the activities of daily living of patients. Previous history of cerebral arterial thrombosis,insufficient cardiac function,and consistent atrial fibrillation are influencing factors for acute ischemic stroke during hospitalization after RFCA. The preoperative screening and the strict control of indications may help reduce the complication of acute ischemic stroke after RFCA.关键词
心房颤动/心脏射频消融术/卒中/影响因素分析Key words
Atrial fibrillation/Cardiac radiofrequency ablation/Stroke/Root cause analysis分类
医药卫生
