关键词: 心房颤动, 射频消融术, 运动耐力, 心肺运动试验, 影响因素分析

Abstract: Background　Low exercise capacity level is associated with high risk of death caused by cardiovascular disease.Exercise capacity may be an important factor affecting quality of life and clinical prognosis for patients with atrial fibrillation（AF）.Even among those with successful radiofrequency ablation，exercise capacity is still not optimistic in general.At present，there are few studies on its current situation and influencing factors in this group.Objective　To investigate the exercise capacity level and its influencing factors among AF patients after radiofrequency ablation.Methods　From May 2018 to June 2019，by use of convenience sampling，189 AF patients with radiofrequency ablation were selected from Department of Cardiovascular Medicine，the First Affiliated Hospital with Nanjing Medical University.A self-developed general situation questionnaire was used to survey their general characteristics.Cardiopulmonary exercise test （CPET） was used to evaluate patients' exercise capacity.Multiple linear regression was used to analyze the influencing factors of exercise capacity.Results　The mean maximal oxygen uptake （VO2max） in the participants was （19.7±6.1）ml?kg-1?min-1.According to the Weber classification in cardiac rehabilitation，VO2max was classified as level A in 85 cases （45.0%），level B in 45 cases （23.8%），level C in 52 cases （27.5%） and level D in 7 cases （3.7%）.The postoperative VO2max differed obviously by sex，age，education level，smoking，drinking，exercise habit，preoperative NYHA class，preoperative EHRA class，and BMI （P<0.05）.Multiple linear regression analysis revealed that exercise habit 〔β=3.956，95%CI（2.746，5.269）〕，preoperative EHRA score 〔β=-4.651，95%CI（-5.318，-3.983）〕，and BMI 〔β=-0.224，95%CI（-0.383，-0.066）〕 were associated factors of VO2max in patients with AF after radiofrequency ablation（P<0.05）.Conclusion　Despite the success of radiofrequency ablation for patients with AF，there is still varying degrees of decline in exercise capacity in the short term.Clinical interventions should be taken according to exercise habit，preoperative EHRA score，and BMI of patients to promote the improvement of exercise capacity and quality of life.

Key words: Atrial fibrillation, Radio frequency ablation, Exercise capacity, Cardiopulmonary exercise test, Root cause analysis