家庭运动对心房颤动患者导管消融术后复发的影响
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上海市浦东新区卫生健康委员会面上项目(PW2021A-30),国医大师严世芸浦东传承工作室资助项目(YC-2023-0119).


Effect of home-based exercise on atrial fibrillation recurrence after catheter ablation
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Supported by General Project of Health Commission of Shanghai Pudong New Area (PW2021A-30) and Fund of YAN Shiyun Inheritance Studio of National TCM Masters of Pudong (YC-2023-0119).

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    摘要:

    目的 探讨家庭运动对心房颤动患者导管消融术后复发的作用。方法 本研究为单中心、前瞻性随机对照试验,纳入112例明确诊断为心房颤动且心脏超声检查显示左心房内径<50 mm的患者,随机分为家庭运动组和对照组(各56例)。家庭运动组于导管消融术后1个月基于心肺康复评估结果制定个体化有氧运动方案,每周3次、每次30 min,运动时心率维持在峰值心率的60%~70%,持续1年;对照组维持原有生活方式,不施加额外运动干预。术后随访1年,以术后4~12个月经24 h动态心电图记录到的心房颤动、心房扑动或房性心动过速(持续时间≥30 s)为主要终点。结果 Kaplan-Meier生存曲线分析显示,家庭运动组心房颤动患者导管消融术后复发风险低于对照组(log-rank检验,P=0.045)。单因素Cox回归分析显示,家庭运动可降低心房颤动患者导管消融术后复发风险(HR=0.35,95%CI 0.22~0.98,P=0.045);多因素Cox回归分析显示,校正不均衡因素后,家庭运动仍是预防心房颤动患者导管消融术后复发的独立保护因素(HR=0.29,95%CI 0.09~0.98,P=0.046)。结论 家庭运动是心房颤动患者导管消融术后复发的独立保护因素,建议将其纳入术后管理方案。

    Abstract:

    Objective To investigate the effect of home-based exercise on recurrence of atrial fibrillation (AF) after catheter ablation. Methods This was a single-center, prospective randomized controlled trial. A total of 112 patients diagnosed with AF whose left atrial diameter was less than 50 mm on echocardiography were enrolled and randomly assigned to home-based exercise group or control group (56 patients each). Starting 1 month post-ablation, the home-based exercise group received individualized aerobic exercise regimens based on cardiopulmonary rehabilitation assessment, performed 3 times weekly for 30 min per session, with heart rate maintained at 60%-70% of peak heart rate, for 1 year; the control group maintained their original lifestyle without additional exercise intervention. All patients were followed for 1 year postoperatively. The primary endpoint was defined as AF, atrial flutter, or atrial tachycardia lasting ≥30 s recorded on 24 h Holter monitoring between 4 and 12 months post-ablation. Results Kaplan-Meier survival analysis revealed that the risk of recurrence after catheter ablation for AF was significantly lower in the home-based exercise group than in the control group (log-rank test, P=0.045). Univariate Cox regression analysis demonstrated that home-based exercise reduced the recurrence risk following catheter ablation in patients with AF (hazard ratio [HR] =0.35, 95% confidence interval [95%CI] 0.22-0.98, P=0.045); multivariate Cox regression analysis revealed, after adjusting for confounding factors home-based exercise remained an independent protective factor against post-ablation recurrence of AF (HR=0.29, 95%CI 0.09-0.98, P=0.046). Conclusion Home-based exercise is an independent protective factor against AF recurrence after catheter ablation and should be incorporated into the post-ablation management plan.

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  • 收稿日期:2025-07-06
  • 最后修改日期:2025-10-14
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  • 在线发布日期: 2026-06-27
  • 出版日期: 2026-06-20
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