体质量指数与心房颤动消融术后晚期复发的关系

Objective: To analyze the relationship between obesity-related indexes and recurrence after atrial fibrillation ablation. Methods: The 319 patients who underwent catheter ablation for paroxysmal atrial fibrillation were included. According to the recurrence of atrial fibrillation after ablation, they were divided into recurrence group(91 cases) and non-recurrence group(228 cases). According to whether the postoperative recurrence time was within 1 year, the recurrent patients were divided into late recurrence group(49 cases) and very late recurrence group(42 cases). Cox regression analysis was used to explore the risk factors of recurrence group, late recurrence of atrial fibrillation group and very late recurrence group. Then, the receiver-operating characteristic curve analysis was used to analyze the value of obesity index to predict the recurrence of atrial fibrillation. Results: (l)BMI of recurrent group was higher than that of non-recurrent group[(26. 70 ± 2. 69) kg/m²vs(24. 38 ± 2. 17) kg/m²], waist circumstance(WC), waist-to-hip ratio(WHtR), lipid Accumulation Product(LAP), visceral obesity index(VAI), cardiometabolic Index(CMI), body fat index(BAI) and other obesity indexes were also higher than those of the non-recurrent group(all P<0. 05); (2)BMI of late recurrence group was higher than that of very late recurrence group[(27. 68 ± 2. 50) kg/m²vs(25. 56 ± 2. 47) kg/m²], WHR, VAI were also higher than those of the very late recurrence group(all P<0. 05); (3)Multiple Cox regression analysis showed that the independent predictors of late recurrence(recurrence within one year) were BMKHR: 1. 269, 95%C7: 1. 131 - 1. 423), VAI (HR: 1. 004, 95%CI: 1. 001-1. 007) and white blood cell countCHR: 1. 232, 95%CI . 1. 032-1. 470). The independent predictors of very late recurrence(recurrence after 1 year) were coronary heart disease, neutrophil count and fasting blood glucose(all P<0. 05); (4)ROC curve analysis showed that the value of BMI in predicting recurrence of atrial fibrillation within one year after ablation(AUC = 0. 822, P = 0. 036, 95 % CI: 0. 752 - 0. 892) was higher than of VAI(AUC=0. 645, P = 0. 001, 95%CJ: 0. 567-0. 792). Conclusion: BMI is the obesity index to predict late recurrence of atrial fibrillation after ablation.