摘要
Abstract
Objective:To investigate the factors associated with the recurrence of(atrial fibrillation,AF)1 year after(Ra-diofrequency ablation,RFA),and to construct a predictive model and evaluate its clinical performance.Methods:A total of 228 AF patients who were underwent their first cardiac RFA were included as the research subjects.The patients were divided into a development set and a validation set.Univariate and multivariate Logistic regression analyses were employed to identify inde-pendent risk factors for recurrence after RFA using the included variables.A nomogram model for predicting 1-year recurrence after RFA was constructed using R software.Finally,the model was validated and evaluated through concordance statistics,cali-bration plots,and decision curve analysis,respectively.Results:Multivariate Logistic regression analysis revealed that the type of atrial fibrillation(OR=0.107,95%CI:0.034～0.299,P<0.001),hypertension(OR=2.844,95%CI:1.064～8.117,P=0.042),subclinical thyroid dysfunction(OR=12.786,95%CI:2.063～86.374,P=0.007),Left Atrial Diameter(LAD,OR=1.178,95%CI:1.052～1.335,P=0.006),and Lipoprotein(a)[Lp(a),OR=1.002,95%CI:1.001～1.004,P=0.008]were all independent risk factors for AF recurrence 1 year after RFA.The nomogram developed based on these factors demonstrated a concordance index of 0.846(95%CI:0.785～0.905)in the development set for predicting AF recurrence 1 year after RFA,and a concordance index of 0.744(95%CI:0.601～0.890)in the validation set.Internal validation of the model through 1,000 bootstrap resampling showed that the calibration curve indicated a good agreement between the nomogram's predicted out-comes and the observed outcomes.Decision curve analysis suggested that the nomogram exhibited good predictive ability in both the development and validation sets.Conclusion:The nomogram model constructed based on atrial fibrillation type,LAD,hyper-tension,subclinical thyroid dysfunction,and Lp(a)demonstrates good discrimination and accuracy.It has certain predictive val-ue for atrial fibrillation recurrence one year after RFA,and aids clinicians in formulating individualized patient recurrence risk assessments.关键词
心房颤动/射频消融术/复发/危险因素/列线图Key words
Atrial fibrillation/Radiofrequency ablation/Recurrence/Risk factors/Nomogram分类
医药卫生
