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目的评价HATCH评分对心房颤动同步直流电复律术后复发的预测价值。方法2008年1月至2011年12月大连医科大学附属第一医院住院行同步直流电复律治疗心房颤动的患者102例(持续性房颤,症状明显行紧急电复律者12例,持续性房颤择期电复律者54例,房颤消融术围手术期电复律者36例),对上述患者进行HATCH评分(HATCH评分标准:H高血压病1分、A年龄>75岁1分、T短暂脑缺血或脑卒中2分、C慢性阻塞性肺疾病1分、H心力衰竭2分)。术后电话随访1年,分别在3、6、12个月行心电图及动态心电图检查。术后1年内,有心电图或动态心电图记录>30s心房颤动定义为复发组,维持窦性心律者为未复发组。结果心房颤动复发组53例(52.0%),未复发组49例(48.0%)。HATCH评分0、1、≥2分组分别为37例(36.3%)、30例(29.4%)和35例(34.3%)。复发组HATCH评分明显高于非复发组(1.81±1.4比0.61±0.7,P<0.05),提示HATCH评分对心房颤动同步直流电复律术后复发有预测价值。其中复发组中HATCH评分为0、1和≥2分者分别为11例(20.8%)、14例(26.4%)和28例(52.8%),未复发组中HATCH评分为0、1和≥2分者分别为26例(53.1%)、16例(32.6%)和7例(14.3%),复发组中HATCH≥2分者明显多于未复发组,差异有统计学意义(P<0.05)。结论 HATCH评分对心房颤动同步直流电复律术后复发有一定的预测价值。HATCH评分≥2分者电复律术后房颤复发的几率大。
Objective To evaluate the predictive value of HATCH score for recurrence after atrial fibrillation synchronous DC cardioversion. Methods From January 2008 to December 2011, 102 patients with persistent atrial fibrillation undergoing ambulatory DC cardioversion at the First Affiliated Hospital of Dalian Medical University were enrolled in this study. Persistent atrial fibrillation was observed in 12 patients with persistent atrial fibrillation Hutchinson’s disease was evaluated by HATCH score (HATCH score: 1 point for Hypertension, 1 point for A age> 75 years, T transient cerebral ischemia or stroke 2 points, C chronic obstructive pulmonary disease 1 point, H heart failure 2 points). Follow-up phone after 1 year, respectively, at 3,6,12 months, ECG and Holter examination. Within 1 year after surgery, ECG or Holter recording> 30s of atrial fibrillation was defined as recurrence group, sinus arrhythmia was not recurrence group. Results Atrial fibrillation recurrence group of 53 patients (52.0%), 49 cases of non-recurrence group (48.0%). HATCH score 0,1, ≥2 group were 37 cases (36.3%), 30 cases (29.4%) and 35 cases (34.3%). The HATCH score in the relapse group was significantly higher than that in the non-recurrence group (1.81 ± 1.4 vs 0.61 ± 0.7, P <0.05), suggesting that the HATCH score has predictive value for the recurrence after atrial fibrillation synchronous DC cardioversion. Among them, 11 (20.8%), 14 (26.4%) and 28 (52.8%) had HATCH scores of 0, 1 and ≥ 2 in the recurrence group, respectively, and HATCH scores of the non-recurrence group were 0, 1 and ≥ 26 cases (53.1%), 16 cases (32.6%) and 7 cases (14.3%) were found in 2 cases, and there were more HATCH≥2 points in recurrence group than those in non-recurrence group (P <0.05) ). Conclusions The HATCH score has some predictive value for the recurrence of atrial fibrillation synchronous DC cardioversion. HATCH score ≥ 2 points after cardioversion atrial fibrillation recurrence probability.