2026 年第 7 期 第 21 卷

术后早期电话随访与心房颤动射频消融患者药物依从性及短期结局的关系

Association of early postoperative telephone follow-up with medication adherence and short-term outcomes in patients undergoing radiofrequency ablation for atrial fibrillation

作者：马艾1刘畅1石继慧1赵一泽1王雯玉1何柳2赵小湃1马长生1

英文作者：Ma Ai1 Liu Chang1 Shi Jihui1 Zhao Yize1 Wang Wenyu1 He Liu2 Zhao Xiaopai1 Ma Changsheng1

单位：1首都医科大学附属北京安贞医院心律失常中心，北京100029；2首都医科大学附属北京安贞医院心血管防治办公室，北京100029

英文单位：1Arrhythmia Center Beijing Anzhen Hospital Capital Medical University Beijing 100029 China; 2Cardiovascular Prevention and Control Office Beijing Anzhen Hospital Capital Medical University Beijing 100029 China

关键词：心房颤动；导管消融；电话随访；药物依从性；术后并发症

英文关键词：Atrialfibrillation;Catheterablation;Telephonefollow-up;Medicationadherence;Postoperativecomplications

• 摘要：

• 目的 探讨在常规随访基础上，对心房颤动导管消融术后患者增加术后早期（1个月内）主动电话随访，对其围术期用药依从性、临床结局事件发生率及再就诊情况的影响。方法 本研究采用回顾性队列研究设计，纳入2025年1月在首都医科大学附属北京安贞医院接受心房颤动择期手术的547例患者作为干预组，在术后1个月内接受1次主动电话随访；纳入2025年2月在本院接受择期手术的893例患者作为对照组，仅接受常规的术后3个月首次门诊随访。电话随访内容包括核实医嘱理解、指导药物服用、解答疑问、评估术后恢复情况、识别异常症状并提供就医指导、进行心理支持等。主要结局指标为术后6个月药物依从性，次要结局指标包括术后6个月内血栓栓塞事件、出血事件及再就诊情况。结果 在术后6个月药物依从性方面，干预组持续遵循CHA2DS2-VASc评分服用抗凝药物的患者比例显著高于对照组［53.9%(295/547)比42.9%(383/893)］（χ2=16.598，P＜0.001）；干预组遵医嘱停用抗心律失常药比例显著高于对照组［82.8%(453/547)比77.5%(692/893)］（χ2=6.274，P=0.012）。2组血栓栓塞和出血事件发生率比较，差异均无统计学意义（均P＞0.05）。在再就诊情况方面，因心血管疾病门诊就诊的发生率中，干预组显著高于对照组［8.4%(46/547)比4.9%（44/893）］（P=0.008），2组因心血管疾病急诊就诊（P=0.174）、因心血管疾病住院（P=0.627）以及因心血管原因再次就诊或住院（P=0.053）发生率比较差异均无统计学意义。结论 心房颤动射频消融术后早期主动电话随访可显著改善患者抗凝及抗心律失常药物的用药依从性，且未增加短期不良事件风险。该随访模式可作为常规门诊随访的补充手段。

• Objective To explore the impact of active telephone follow-up within 1 month after catheter ablation for atrial fibrillation (AF) on perioperative medication adherence, incidence of clinical outcome events and rehospitalization rates based on routine follow-up. Methods A retrospective cohort study was conducted. A total of 547 patients who underwent elective AF surgery at Beijing Anzhen Hospital, Capital Medical University in January 2025 were enrolled as the intervention group, receiving one active telephone follow-up within 1 month after surgery; 893 patients who underwent elective surgery at our hospital in February 2025 were included as the control group, only receiving routine first outpatient follow-up at 3 months after surgery. The telephone follow-up included verifying understanding of medical advice, guiding medication administration, answering questions, evaluating postoperative recovery, identifying abnormal symptoms and providing medical guidance, and offering psychological support. The primary outcome was medication adherence at 6 months postoperatively, and secondary outcomes included thromboembolic events, bleeding events and rehospitalization within 6 months postoperatively. Results In terms of medication adherence at 6 months postoperatively, the proportion of patients in the intervention group who continuously adhered to anticoagulant medication according to the CHA2DS2-VASc score was significantly higher than that in the control group ［53.9%(295/547) vs 42.9%(383/893)］(χ2=16.598, P＜0.001); the proportion of patients in the intervention group who discontinued antiarrhythmic drugs as directed was significantly higher than that in the control group ［82.8%(453/547) vs 77.5%(692/893)］(χ2=6.274, P=0.012). There was no significant difference in the incidence of thromboembolic and bleeding events between the two groups (both P＞0.05). In terms of rehospitalization, the incidence of outpatient visits for cardiovascular diseases in the intervention group was significantly higher than that in the control group ［8.4%(46/547) vs 4.9%（44/893）］(P=0.008). There were no significant differences between the two groups in the incidence of emergency visits for cardiovascular diseases (P=0.174), hospitalization for cardiovascular diseases (P=0.627), and re-visits or hospitalization for cardiovascular reasons (P=0.053). Conclusion Early active telephone follow-up after radiofrequency ablation for AF can significantly improve patients′ adherence to anticoagulant and antiarrhythmic medications without increasing the risk of short-term adverse events. This follow-up model can serve as a supplementary method to routine outpatient follow-up.