Changes And Significances Of ECG Scatter Data In Patients With Atrial Fibrillation Before And After Radiofrequency Ablation

BackgroundAtrial fibrillation(AF)is the most common rapid arrhythmia in clinic,with a high disability rate and fatality rate.It is believed that multiple factors and complex mechanisms are involved in the occurrence and maintenance of AF.Radiofrequency catheter ablation(RFCA)is an important interventional method for treating AF.However,the recurrence rate after the first ablation of AF is relatively high(25%-60%),so it is a hot topic to discuss the risk factors and prediction methods of the recurrence of AF.Previous studies have shown that the functional early changes of the autonomic nervous system(ANS)in patients with AF after RFCA can affect the later recurrence of AF.Arrhythmia events after RFCA have also been shown to predict late recurrence of AF.Dynamic electrocardiogram is one of the most commonly used tools for recording ECG big data.It can present long-term ECG information completely and continuously.Combined with ECG scattered graph analysis method,it can not only probe arrhythmia events efficiently and accurately,but also reveal the abundant ECG information and possible cardiac pathophysiological changes in sinus rhythm and ectopic rhythm.Aims1.Long-term ECG big data combined with scatter diagram technology is used to observe and analyze the changes of ECG big data characteristics of patients with paroxysmal atrial fibrillation(PAF)before and after RFCA.2.Long-term ECG big data combined with scatter diagram technology is used to observe and analyze the differences of early ECG big data characteristics in patients with PAF and patients with persistent atrial fibrillation(PeAF)after RFCA.3.Long-term ECG big data combined with scatter diagram technology is used to observe and analyze the similarities and differences of early ECG big data characteristics in patie nts with AF after RFCA between the recrrence group and the non-recurrence group,and to explore the relationship between the early ECG big data characteristics and late recurr ence of AF after RFCA.Methods60 patients with AF who underwent RFCA for the first time in the Department of Cardiology of the First Affiliated Hospital of Shandong First Medical University(Shandong Provincial Qianfoshan Hospital)from October 2018 to February 2021 are collected as the research objects.The patients are divided into PAF group and PeAF group according to the diagnosis type of AF before RFCA.The patients are divided into recurrence group and non-recurrence group according to whether AF recurred after 3 months of RFCA.The long-term holter ECG recorder produced by Hangzhou Baihui Medical Equipment Co.,Ltd.is used to record 24h holter electrocardiogram of patients with AF before RFCA(within 3 days)and in the early postoperative period(within 3 days).The nonlinear indexes of heart rate variability(HRV)scatter plot,time domain indexes,frequency domain indexes and ECG scatter big data characteristics of atrial arrhythmia in patients with AF before and after RFCA are observed and analyzed.General datas such as biochemical indexes,cardiac ultrasound indexes and past medical history are collected and analyzed.Results1.Changes of ECG scatter big data characteristics before and after RFCA in PAF group:standard diviation of intervals between adjacent sinus RR intervals within 24h after RFCA(SDNN),standard deviation of all 5-min averaged intervals(SDANN),low frequency(LF),and long axis of scatter plot(SD2)are lower than the preoperative,the differences are statistically significant(all P<0.01).The morphological differences,short axis of scatter plot/long axis of scatter plot(SD1/SD2)and high frequency(HF)levels in sinus heart rate steady-state attractors are lower than those before surgery,with statistical significance(all P<0.05).There are no significant differences in short axis of scatter plot(SD1)and low frequency/high frequency(LF/HF)(all P>0.05).The incidence of atrial concurrent rhythm is higher after operation than before,and the difference is statistically significant(P<0.05).There are no significant differences in the incidence of frequent atrial premature beats(referred to as frequent atrial premature beats),short array atrial tachycardia(referred to as short array atrial tachycardia)and AF(all P>0.05).2.Differences in big data characteristics of postoperative ECG scatter between PAF group and PeAF group:the baseline data of the two groups show statistically significant differences in preoperative average heart rate,left atrial diameter(LAD)and brain natriuretic peptide(BNP)(all P<0.05).There are no statistical significance in other general datas(all P>0.05).There are no difference in sinus heart rate HRV indexs between PAF group and PeAF group(all P>0.05).The incidences of short atrial tachycardia and atrial concurrent rhythm in PAF group are lower than that in PeAF group,statistical differences(all P<0.05).There are no differences in the incidence of frequent atrial premature,AF and atrial flutter between the two groups(all P>0.05).3.Differences and similarities in ECG scatter big data characteristics after RFCA between the recrrence group and the non-recrrence group:there is no statistical significance in baseline data and sinus heart rate HRV index between the two groups(P>0.05).The incidence of frequent atrial premature beats in the recrrence group is significantly higher than that in the non-recurrence group,and the difference is statistically significant(P<0.01).The incidence of atrial concurrent rhythm in the recurrence group is higher than that in the non-recurrence group,and the difference is statistically significant(P<0.05).There are no significant differences in mean heart rate,the incidences of short atrial tachycardia and AF between the two groups(all P>0.05).Logistic regression analysis show that,frequent atrial premature beats odds ratio(OR)=8.503,95%confidence interval(CI)=2.047-35.323,P<0.05;atrial concurrent rhythm OR=2.920,95%CI=0.734-11.61,P=0.128.Conclusions1.The activity of ANS of patients with PAF after RFC A is generally decreased in the early postoperative period,of which the activity of vagus nerve is decreased while the activity of sympathetic nerve is increased.Atrial concurrent rhythm is an important arrhythmia event after RFCA.2.Atrial arrhythmias occur early after RFCA in both PAF and PeAF patients and presented their own scatter plot characteristics,but the latter is more likely to develop short array atrial tachycardia and atrial concurrent rhythm.3.Early ECG scatter information of patients with AF after RFCA provide strong evidence for atrial arrhythmia to predict the late recurrence of AF;frequent atrial premature is an independent risk factor for late recurrence of AF after RFCA,and atrial concurrent rhythm increases the risk of late recurrence of AF.