EUR HEART J SUPPL｜1049例卵圆孔未闭术后心房颤动的患病率和肺静脉隔离的可行性（附源文）

1049 PREVALENCE OF ATRIAL FIBRILLATION AND FEASIBILITY OF PULMONARY VEIN ISOLATION AFTER PATENT FORAMEN OVALE CLOSURE

EUR HEART J SUPPL   Dec 01, 2022: 24 (Supplement_K),   10.1093/eurheartjsupp/suac121.043  

Data about prevalence and the risk of atrial fibrillation, stroke, and need for pulmonary vein isolation (PVI) after device closure of a patent foramen ovale (PFO) are still lacking.

关于房颤、中风的患病率和风险，以及卵圆孔未闭（PFO）封堵器后肺静脉隔离（PVI）的需求的数据仍然缺乏。

We aim to investigate the prevalence and the risk of atrial fibrillation after PFO closure and the feasibility of PVI in a PFO closure cohort compared to contemporary PVI without PFO closure.

我们的目的是研究PFO封堵术后心房颤动的患病率和风险，以及与未经PFO封堵的同期PVI相比，PFO封堵队列中PVI的可行性。

retrospective observational study of consecutive patients undergoing PFO closure enrolled from February 2013 to September 2020. Patients were divided into 3 groups: i) patients without AF before and after the procedure (n=132), ii) patients with paroxysmal AF prior to the procedure (n=21), iii) patients with documented AF after the procedure (n=13). All patients with AF occurrence were treated with adequate anticoagulation therapy according to the current ESC Guidelines. We compared the procedural data of these patients to a matched contemporary cohort without previous PFO closure undergoing PVI in our center. AF and stroke prevalence and PVI feasibility after PFO closure were assessed at follow up.

对2013年2月至2020年9月接受PFO封堵术的连续患者进行的回顾性观察研究。患者被分为3组：i）术前和术后无房颤的患者（n=132），ii）术前有阵发性房颤的病人（n=21），iii）术后有记录的房颤患者（n=13）。所有发生房颤的患者均按照现行ESC指南进行了充分的抗凝治疗。我们将这些患者的手术数据与在我们中心进行PVI的既往无PFO闭合的匹配当代队列进行了比较。在随访时评估PFO关闭后房颤和中风的发生率以及PVI的可行性。

one-hundred and sixty-six consecutive PFO closure patients were enrolled; the mean age was 54 ± 13 years. Median follow-up was 3.5 2.5 years. During the study period, 21 patients had AF before or after the PFO closure (group 2) and 13 (7.8%) new onset AF (group 3). Stroke after the PFO closure occurred in 8 patients (4.8%), of which 4 in the group with new onset AF (30% of the group 3).

一百六十六名连续的PFO闭合患者被纳入研究；平均年龄54±13岁。中位随访时间为3.5 2.5年。在研究期间，21名患者在PFO闭合之前或之后出现AF（第2组），13名（7.8%）新发AF（第3组）。8名患者（4.8%）在PFO封堵术后发生中风，其中4名患者为新发AF患者（3组中30%）。

Among the 34 patients with AF, 10 patients (6%) underwent a PVI. Compared to a contemporary matched PVI cohort, total procedural times and fluoroscopy times were significantly higher in the patients with previous PFO closure (108±15 vs 75±29, p=0.002 and 3±1.5 vs 8±7, p<0.001). Similar rate of AF relapses (p=0.198) was observed between the two groups, with a trend for higher rate of complication (pericardial effusion) for the cohort with previous PFO closure (p=0.06).

在34名房颤患者中，10名患者（6%）接受了PVI。与当代匹配的PVI队列相比，既往PFO闭合的患者的总手术时间和荧光检查时间显著更高（108±15 vs 75±29，p=0.002和3±1.5 vs 8±7，p<0.001）。两组房颤复发率相似（p=0.198），既往PFO封堵的患者有更高的并发症发生率（心包积液）的趋势（p=0.06）。

This study shows that a more accurate screening and treatment of AF is needed in patients with cryptogenic stroke despite the presence of a PFO, possibly a bystander. In our study, 30% of patients with new onset AF after PFO closure, experienced a further stroke after the procedure. In case of AF, the indication for PVI should be considered prior to the PFO closure since it turns out to be more difficult in terms of procedural and fluoroscopy times and risks of complications after PFO closure.

这项研究表明，尽管存在PFO，可能是旁观者，但隐源性中风患者仍需要更准确的AF筛查和治疗。在我们的研究中，30%的PFO关闭后新发AF患者在手术后经历了进一步的中风。在房颤的情况下，应在PFO闭合前考虑PVI的适应症，因为PFO闭合后，PVI在手术和荧光检查时间以及并发症风险方面更加困难。

1049 PREVALENCE OF ATRIAL FIBRILLATION AND FEASIBILITY OF PULMONARY VEIN ISOLATION AFTER PATENT FORAMEN OVALE CLOSURE

EUR HEART J SUPPL   Dec 01, 2022: 24 (Supplement_K),   10.1093/eurheartjsupp/suac121.043