| Objective The study was aimed to evaluate the preoperative sleep quality of patients with atrial fibrillation(AF),and analyze its effect on the recurrence after atrial fibrillation catheter ablation.These risk factors related to the recurrence and their predictive value were also explored.Methods We retrospectively enrolled patients with AF from April 2018 to October 2019,who underwent cryoballoon ablation or radiofrequency catheter ablation with the guidance of Carto 3 mapping system(Biosense Webster)in the Department of Cardiovascular Internal Medicine of the Zhong Da Hospital Affiliated to Southeast University,and patients preoperative sleep quality was evaluated by the Pittsburgh Sleep Quality Index Scale(PSQI).We collected their baseline data and other surgeryrelated information before surgery,and recorded relapse in 7 days after ablation and the medication within three months after the operation,mainly anti-arrhythmic drugs such as amiodarone,propafenone and betaloc.Follow-up was performed in the first month,the third month,the sixth month,the twelfth month,and the twenty-fourth month after the operation.Statistical analysis was performed with SPSS 19.0.0 software.Result 1.102 patients were totally enrolled,of whom 50 patients are males(49.0%)and 52 patients are females(51.0%),with an average 64.95±9.17(38-83)years old.69 cases were with paroxysmal atrial fibrillation(67.6%),and other 33 cases were with persistent atrial fibrillation(32.4%).52 cases underwent radiofrequency ablation(51.0%),and other 50 patients underwent cryoballoon ablation(49.0%).After15.27±5.292(6-24,median 14.50)months Follow-up,25 cases(24.5%)met atrial fibrillation recurrence after surgery,and other 77 cases(75.5%)did not relapse.2.There were no statistical difference between patients with atrial fibrillation recurrence and patients without recurrence in age,height,weight,total serum cholesterol(TC),high density lipoprotein(HDLc),serum free triiodothyronine(FT3),neutrophil/lymphocyte ratio(N/L),Monocyte/high density lipoprotein ratio(M/Hc),serum triglyceride(TG),low density lipoprotein(LDLc),troponin I(TNI),alanine aminotransferase(ALT),aspartate aminotransferase(AST),serum creatinine(Cr),serum free thyroxine(FT4),thyrotropin(TSH),left ventricular diameter(LVD),CHA2DS2-VASc score,HAS-BLED score.The creatinine Clearance rate(Ccr)of non-relapse group was significantly higher than relapse group.The left atrial diameter(LAD)of non-relapse group was significantly lower than that of relapse group,and the body mass index(BMI)and left ventricular ejection fraction(LVEF)of nonrelapse group rank significantly higher than relapse group.3.The PSQI score of all cases was 6.55±4.01,and the scores were subjective sleep quality(1.31±0.70),sleep latency(1.01±0.85),sleep duration(1.23±1.12),sleep efficiency(1.14±1.20),sleep disturbances(0.82±0.41),use of sleeping medication(0.38±0.90),and daytime dysfunction(0.66±0.84),separately.Among these,the results of univariate analysis showed that only sleep efficiency differed between the relapsed and non-relapsed groups(Z=-2.712,P=0.007).4.Multi-factor logistical regression analysis showed that sleep efficiency was an independent risk factor for AF recurrence.5.ROC curve analysis showed that the sleep efficiency score>0.5 was the best critical point for predicting AF recurrence.The area under the curve was 0.658 [95%CI:0.539～0.778].And the sleep efficiency>0.5 probably predicted the recurrence of atrial fibrillation with a sensitivity of 80% and a specificity of 51.9%;While sleep efficiency combined with LAD,atrial fibrillation type,LAD and atrial fibrillation type,the area under the ROC curves was larger than sleep efficiency.However,the difference is not statistically significant.ConclusionSleep efficiency is an independent risk factor for atrial fibrillation recurrence after atrial fibrillation ablation.A sleep efficiency score of >0.5 has a good predictive value. |
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