基于运动的心脏康复对房颤导管消融术后患者有效性的荟萃分析

摘要/Abstract

摘要： 目的系统评价基于运动的心脏康复对射频消融术后患者的有效性。方法检索PubMed、EMBase、The Cochrane Library、中国知网、万方数据库、维普数据库等数据库,筛选有关基于运动训练的心脏康复对房颤射频消融术后患者有效性的随机对照研究。将患者分为心脏康复组和对照组,比较术后房颤复发率、最大摄氧峰值、六分钟步行试验等指标。采用Revman 5.3进行Meta分析。结果最终纳入9篇文献,包括患者 976例,其中有心脏康复组 499例,对照组473例。Meta分析结果显示,心脏康复组导管消融术后房颤复发率低于对照组[RR=0.77,95%CI（0.63,0.92）,P=0.005],心脏康复组Peak VO₂改善[MD=4.77,95%CI（1.16,8.38）]、6WMT改善[MD=25.80,95%CI（16.25,35.35）,P<0.00001],均优于对照组,差异有统计学意义（P<0.05）。结论现有证据表明,心脏运动康复可减少房颤患者射频消融术后房颤的复发,改善患者Peak VO₂、6WMT指标。

关键词: 心脏康复, 心房颤动, 导管消融, Meta分析

Abstract: Objective To investigate the efficacy of exercise-based cardiac rehabilitation in patients with atrial fibrillation after catheter ablation. Methods Databases including PubMed, Embase, the Cochrane Library, CNKI, Wanfang Data, and VIP were searched for randomized controlled trials on the efficacy of exercise-based cardiac rehabilitation in patients with atrial fibrillation after catheter ablation. The patients were divided into cardiac rehabilitation group and control group, and the two groups were compared in terms of the recurrence rate of atrial fibrillation after surgery, peak oxygen uptake, and 6-minute walk test (6WMT) results. Revman 5.3 was used to perform the meta-analysis. Results A total of 9 articles were included, involving 976 patients in total, and there were 499 patients in the cardiac rehabilitation group and 473 patients in the control group. The meta-analysis showed that compared with the control group, the cardiac rehabilitation group had a significantly lower recurrence rate of atrial fibrillation after surgery (risk ratio = 0.77, 95% confidence interval [CI]: 0.63-0.92, P = 0.005) and significantly better improvements in peak oxygen uptake (mean difference [MD] = 4.77, 95% CI: 1.16-8.38, P <0.05) and 6WMT results (MD = 25.80, 95% CI: 16.25-35.35, P<0.00001). Conclusion Current evidence shows that exercise-based cardiac rehabilitation can reduce the recurrence of atrial fibrillation after surgery and improve peak oxygen uptake and 6WMT results in patients with atrial fibrillation.

Key words: Cardiac rehabilitation, Atrial fibrillation, Catheter ablation, Meta-analysis

曹斌, 吕青山, 马冰宁, 文绍勋, 邓振兴. 基于运动的心脏康复对房颤导管消融术后患者有效性的荟萃分析[J]. 心血管病防治知识, 2025, 15(15): 57-62.

CAO Bin, LYU Qingshan, MA Bingning, WEN Shaoxun, DENG Zhenxin. Efficacy of exercise-based cardiac rehabilitation in patients with atrial fibrillation after catheter ablation: A meta-analysis[J]. Prevention and Treatment of Cardiovascular Disease, 2025, 15(15): 57-62.

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