| Objective: To analyze the clinical data and postoperative follow-up results of patients with symptomatic atrial fibrillation who underwent the second generation cryoballoon ablation or quantitative radiofrequency ablation under Visitag module and ablation index guidance for the first time,compare the efficacy and safety of this two ablation catheters,and explore the risk factors of late recurrence after atrial fibrillation ablation Retrospectively.Methods: A study of 248 consecutive patients with symptomatic atrial fibrillation who underwent catheter ablation for the first time between October 2019 and October 2020 in Fu Jian Medical University Union Hospital.Among them,18 cases were lost after operation.So a total of 230 patients were actually included.The patients were divided into RFCA-AI(Radiofrequency Ablation-Ablation Index)group or second generation cryo-balloon ablation(CBA-2)group according to different surgical procedures.We collected clinical data,operation time,exposure time and dosage of X line of them.Follow-up at 3,6,9,12 and 15 months after the operation to record the symptoms and complications.The patient were informed by telephone to return to hospital for a 24-hour ambulatory electrocardiogram.Atrial tachycardia,atrial flutter,and atrial fibrillation recorded in the 12-lead electrocardiogram or 24-hour ambulatory electrocardiogram were identified as late recurrence of atrial fibrillation.The complications and late recurrence rate of atrial fibrillation were compared between the two groups.Then,according to whether late recurrence or not,the patients were divided into recurrent or non-recurrence groups to explore predictors of late recurrence of atrial fibrillation after catheter ablation.Results :A total of 230 patients were followed up.92 cases in CBA-2 group,which median follow-up time was 9(6,13)months.138 cases in RFCA-AI group,which median follow-up time was 8(5,12)months.There was no significant difference in follow-up time(P=0.11)between two of them.And there was no significant difference in baseline data between two of them(P>0.05).The late recurrence rate in CBA-2 group was higher than that in RFCA-AI group(P=0.012).Then subgroup analysis were completed.It showed that the late recurrence rate in CBA-2 group was higher than that in RFCA-AI group(P=0.039)in patients with paroxysmal atrial fibrillation(PAF).In patients with persistent atrial fibrillation(Pe AF),there was no difference of the late recurrence rate between the two groups(P=0.21).The operation time of CBA-2 group[85(75,99.5)min ] was shorter than that of RFCA-AI group[100(84.5,120)min],and the exposure time[17.36(13.87,22.49)min vs 5.49(4.00,8.24)min,P<0.0001] and dose of X ray[223.25(149.15,336.95)min vs 109.15(80.75,168.7)min,P<0.0001] were larger than that of RFCA-AI group.Then all patients were divided into recurrent and non-recurrence groups.Their LAD,early recurrence and methods of ablation(Cryoballoon ablation)had significant difference.Multivariate Logistic regression analysis showed that LAD,early recurrence and methods of ablation(Cryoballoon ablation)were independent risk factors for late recurrence after atrial fibrillation ablation.Conclusion :1.For patients with PAF,quantitative radiofrequency ablation’s efficacy is better than the second-generation cryopreservation balloon ablation.For patients with Pe AF,the efficacy of the two groups were equivalent.2.RFCA-AI group had shorter exposure time and lower radiation dose,but the time of operation was longer than CBA-2 group.3.Both quantitative radiofrequency ablation and second generation cryoballoon ablation are safe.All complication rates were equivalent between the two groups.4.Left atrial diameter and early recurrence of atrial fibrillation were independent risk factors for predicting late recurrence after atrial fibrillation ablation. |
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