Analysis Of Relevant Risk Factors For Recurrence After First Radiofrequency Ablation In Patients With Persistent Atrial Fibrillation

Objective:Persistent atrial fibrillation(PsAF)is a relatively common arrhythmia disease in clinical work,with significantly higher risk of embolism than normal people,and high disability rate and high mortality rate,so it is very important for the diagnosis and treatment of PsAF patients.With the development of radiofrequency ablation technology in recent years,more and more PsAF patients have received radiofrequency ablation,which has become an important treatment method.However,recurrence after ablation still occurs in some patients,which brings great troubles to the surgeons and patients.The function of the left atrium is of great significance for the maintenance of normal cardiac function.Therefore,the accurate assessment of the left atrial function in patients with recurrent atrial fibrillation is of great importance.In this study,echocardiography was applied to evaluate the structure and function of the left atrium,and combined with clinical data to analyze and compare the clinical data of patients with and without recurrence after ablation,so as to explore the risk factors of recurrence after radiofrequency ablation in PsAF patients,so as to provide reference for clinical diagnosis and treatment and patient screening.Method:A total of 298 PsAF patients who underwent radiofrequency ablation in the Department of Cardiology,Affiliated Hospital of Qingdao University from July 2018 to July 2019 were collected.Among them,35 patients had recurrence within 1 year and 263 patients had no recurrence.35 patients who had never recurrence were randomly selected as the non-recurrence group.The structure and function of the left atrium and clinical data of the two groups were compared,and the influencing factors related to recurrence after radiofrequency ablation in PsAF patients were analyzed.Logistic regression analysis was used to determine the independent risk factors for recurrence after radiofrequency ablation in PsAF patients.Results:All 298 patients with PsAF successfully recovered sinus rhythm after radiofrequency ablation.At 1-year follow-up,35 patients developed advanced recurrence(3 months after surgery).Univariate analysis showed that there was no significant difference in gender,age and other general information between the two groups(P>0.05).The disease duration,Left atrial diameter(LAD),Left atrial volume(LAV),left atrial active ejection fraction(LAEF),mitral valve early peak flow velocity/mitral ring early diastolic peak myocardial movement(E/e’),pulmonary arterial systolic pressure(PASP),N-terminal pro-brain natriuretic peptide(NT-pro BNP),postoperative P wave dispersion and early recurrence rate were significantly higher than those of non-recurrence group,the difference was statistically significant(P<0.05).Logistic regression analysis showed that disease duration,LAD,LAV and postoperative P wave dispersion were independent risk factors for recurrence after radiofrequency ablation in PsAF patients(P<0.05).Conclusion:The course of disease,LAD,LAV and postoperative P wave dispersion of PsAF patients were independent risk factors for recurrence after radiofrequency ablation in PsAF patients,which had a guiding role in the assessment of postoperative recurrence risk in PsAF patients.The analysis of the structure and function of the left atrium by echocardiography can be used to guide the screening of PsAF patients who are suitable for radiofrequency ablation and further improve the benefit of patients.