| Abstract | Uvod:. Uspjeh ablacije se procjenjuje praćenjem stope recidiva aritmije. Na pojavu recidiva fibrilacije atrija, nakon ablacijskog liječenja utječe više čimbenika rizika kao što su: demografske karakteristike, komorbiditeti pacijenata te uporaba antiaritmika.
Cilj istraživanja: Cilj istraživanja je analizirati utjecaj demografskih karakteristika i komorbiditeta na stopu recidiva fibrilacije atrija nakon zahvata izolacije plućnih vena u Elektrofiziološkom laboratoriju, Kliničkog bolničkog centra Rijeka.
Ispitanici i metode: U istraživanju su uključeni svi konsekutivni bolesnici s paroksizmalnom i perzistentnom fibrilacijom atrija koji su u razdoblju od 01.01.2020. do 31.03.2022. godine, podvrgnuti zahvatu izolacije plućnih vena. Retrospektivno su prikupljeni podatci o dobi, spolu, visini, težini, komorbiditetima, uzimanju antiaritmika te recidivu fibrilacije atrija. Fibrilacija atrija u trajanju duljem od 30 sekundi dokumentirana u EKG zapisu ili 24-satnim Holter-om smatra se dokazom recidiva.
Rezultati: Od ukupno 177 razmatranih bolesnika njih 162 su zadovoljili kriterije istraživanja. Većina ispitanika, 93 (57,4%), bila je mlađa od 65 godina. Što se tiče tjelesne mase, 39 ispitanika (24,1%) imalo je normalnu tjelesnu masu, 74 ispitanika (45,7%) prekomjernu tjelesnu masu, dok je 49 ispitanika (3,20%) bilo pretilo. Nakon zahvata izolacije plućnih vena, 95 ispitanika (58,6%) je nastavilo liječenje i antiaritmicima, dok 67 ispitanika (58,6%) nije. Ukupno 26 ispitanika (16%) imalo je recidiv fibrilacije atrija tijekom perioda praćenja. Analiza rezultata nije pokazala statistički značajnu povezanost između demografskih karakteristika (spol, dob) i pojave recidiva fibrilacije atrija. Iako se nije dokazala statistički značajna razlika zbog veličine uzorka, postojao je značajan pozitivan trend da pretili bolesnici imaju veću učestalost recidiva fibrilacije atrija (12,8 nasuprot 18,4%, p=0,292). Utvrđeno je da komorbiditeti imaju utjecaj na pojavu recidiva fibrilacije atrija nakon zahvata izolacije plućnih vena (4,6% nasuprot 20,3% p=0,009).
Zaključak: Poznavanje čimbenika koji utječu na incidenciju recidiva fibrilacije atrija može pomoći u boljoj selekciji bolesnika, prilagođavanju terapijskih pristupa i poboljšanju ishoda liječenja. |
| Abstract (english) | Introduction: The success of ablation is evaluated by monitoring the rate of arrhythmia recurrence. The occurrence of atrial fibrillation recurrence after ablation treatment is influenced by multiple risk factors such as demographic characteristics, patient comorbidities, and the use of antiarrhythmic drugs.
Objective: The objective of this study is to analyze the impact of demographic characteristics and comorbidities on the rate of atrial fibrillation recurrence following pulmonary vein isolation procedure in the Electrophysiology Laboratory of the Clinical Hospital Center Rijeka.
Methods: The study included all consecutive patients with paroxysmal and persistent atrial fibrillation who underwent pulmonary vein isolation procedure between January 1, 2020, and March 31, 2022. Retrospectively, data were collected on age, gender, height, weight, comorbidities, use of antiarrhythmic drugs, and occurrence of atrial fibrillation recurrence. Atrial fibrillation lasting longer than 30 seconds documented in an EKG recording or 24-hour Holter monitoring was considered as evidence of recurrence.
Results: Out of the total of 177 patients considered, 162 of them met the study criteria. The majority of participants, 93 (57.4%), were younger than 65 years old. Regarding body mass index, 39 participants (24.1%) had a normal weight, 74 participants (45.7%) were overweight, and 49 participants (31.2%) were obese. After pulmonary vein isolation, 95 participants (58.6%) continued treatment with antiarrhythmic drugs, while 67 participants (41.4%) did not. A total of 26 participants (16%) experienced atrial fibrillation recurrence during the follow-up period. The analysis of the results did not show a statistically significant association between demographic characteristics (gender, age) and the occurrence of atrial fibrillation recurrence. Although a statistically significant difference was not demonstrated due to the sample size, there was a significant positive trend suggesting that obese patients had a higher frequency of atrial fibrillation recurrence (12.8% versus 18.4%, p = 0.292). It was found that comorbidities had an impact on the occurrence of atrial fibrillation recurrence after the pulmonary vein isolation procedure (4.6% versus 20.3%, p = 0.009).
Conclusion: Understanding the factors that influence the incidence of atrial fibrillation recurrence can help in better patient selection, tailoring therapeutic approaches, and improving treatment outcomes. |
