| Objective: To explore the therapeutic value of metoprolol combined with Wenxin granules on atrial tachycardia(atrial tachycardia)after catheter ablation in patients with atrial fibrillation(AF),in order to further reduce the recurrence of AF after catheter ablation,and optimize the anti-arrhythmia treatment plan for AF patients after catheter ablation.Methods: This study selected 290 patients with atrial tachycardia in the blank period(within 3 months)after catheter ablation of AF,but no AF attack.They were randomly divided into four groups: Wenxin granule group(i.e.W group,n=65),metoprolol group(i.e.M group,n=91),metoprolol combined with Wenxin granule group(i.e.MW group,n=88),and blank control group(i.e.C group,n=46).According to the number and distribution characteristics of the patients’ interventioning anterior atrial premature beats,the patients were divided into groups: group Ⅰ: the number of atrial premature beats<1000 times/48 h,group Ⅱ: the number of atrial premature beats1000-3000 times/48 h,group Ⅲ: the number of atrial premature beats>3000 times/48 h.Collect general data of patients,biochemical indexes,dynamic electrocardiogram and echocardiography before and after treatment.The number of atrial tachycardia,the longest atrial tachycardia,the number of atrial premature beats/48 h,the average heart rate,the left atrial diameter(LAD),the left ventricular end-diastolic diameter(LVDd),the N-terminal forebrain natriuretic peptide(NT-Pro BNP),the biochemical results,the recurrence of AF and the adverse reactions during the trial were compared among the four groups.SPSS 26.0 software was used for statistical analysis.result: 1.This study plans to include 290 patients,including 65 in Group W,91 in Group M,88 in Group WM,and 46 in Group C.During the research process,there was1 case of lost follow-up and 8 cases of recurrence in Group W;There were 2 cases of lost follow-up and 10 cases of recurrence in Group M;In the MW group,1 case was lost and 8 cases recurred,while in the C group,1 case was lost and 6 cases recurred.The total loss of follow-up rate was 1.72%(5/290),and the total recurrence rate was 11.23%(32/285).Comparison of postoperative recurrence rates among four groups of patients showed that the recurrence rate in Group W was 12.50%(8/64),M was 11.23%(10/89),MW was 9.19%(8/87),and C was 13.33%(6/45).Compared with the four groups,the MW group had the lowest recurrence rate,but the difference was not significant(P=0.881),with no statistical significance.The final valid data consists of 253 cases.There were 56 cases in the W group,79 cases in the M group,79 cases in the MW group,and 39 cases in the C group.2.Baseline comparison:There were no significant differences in gender,age,Body Mass Index(BMI),previous comorbidities,preoperative AF types,and comorbidities among the four groups of patients(P>0.05).There was no significant difference in cardiac function related indicators(LAD,LVDd,LVEF,and NT proBNP)among the four groups of patients before intervention(P>0.05).3.Efficacy comparison:3.1Changes in atrial tachycardia in the four groups of patients: The number of atrial tachycardia in the three groups of drug intervention decreased compared to 1 year ago,while the number of atrial tachycardia in group C increased compared to 1 year ago.Compare the number of atrial tachycardia in the MW group,M group,W group,and C group after 1 year(6.25 ± 5.86 vs.6.44 ± 5.68 vs.10.33 ± 5.42 vs.13.96 ± 5.01),with the most significant decrease in MW(P<0.05).3.2 Changes in atrial premature beats in each group of four groups of patients: The number of atrial premature beats in each group of patients treated with drug intervention decreased compared to 1 year ago,while the number of atrial premature beats in each group of patients in Group C increased compared to 1 year ago.After one year of follow-up,the number of atrial premature beats in each group of patients in the MW group,M group,W group,and C group was compared as Group I(155.76 ± 128.72 vs.159.14 ± 104.48 vs.240.83 ± 134.00 vs.577.29 ± 275.89,P<0.01).Group II(786.69 ± 202.01 vs.921.91 ± 556.37 vs.1498.17 ± 316.31 vs.2090.81 ± 745.28,P<0.01).Group III(812.20 ± 273.50 vs.1315.68 ± 439.86 vs.2276.20 ± 853.19 vs.3598.44 ± 282.89,P<0.01).The three groups of atrial premature beats showed the most significant reduction in MW,and the differences were statistically significant.3.3 Changes in the longest heart beat frequency of atrial tachycardia in the four groups of patients: The longest heart beat frequency after 1 year of drug intervention in the three groups of patients decreased compared to 1 year ago,while the longest heart beat frequency of atrial tachycardia in group C increased compared to 1 year ago.MW group,M group,W group,and C group patients were compared(6.27 ± 3.82 vs.676 ±3.71 vs.7.22 ± 3.88 vs.12.46 ± 6.06),with the most significant decrease in MW,and the difference was statistically significant(P<0.05).3.4 Average heart rate changes in the four groups of patients: After 1 year of drug intervention,the average heart rate of the three groups of patients decreased compared to 1 year ago,while the average heart rate of group C patients increased compared to 1year ago.Comparing the average heart rate of patients in the MW group,M group,W group,and C group after 1 year(67.56 ± 9.29 vs 68.52 ± 9.77 vs 72.22 ± 9.93 vs75.01 ± 6.49),the average heart rate of patients in the MW group was significantly lower than that of the other three groups(P<0.05).3.5 There was no significant difference in LA,LVD,LVEF and NT-proBNP among the four groups after 1 year follow-up(P>0.05).4.Security comparison:4.1 There was no significant difference in blood routine,liver and kidney function between the four groups after 1 year and before 1 year(P>0.05).4.2 After drug intervention,the incidence of adverse reactions in the three groups were 7.1%(4/56)in group W,13.9%(11/79)in group M,8.9%(7/79)in group MW.The incidence of adverse reactions in group W was the lowest,but there was no significant difference between the three groups(P>0.05).There were no drug-related serious adverse reactions and allergic events in this study.Conclusion:1.After AF ablation,the use of metoprolol combined with Wenxin granules has a certain therapeutic effect on reducing the number of atrial tachycardia,the longest heart beat,average heart rate,and atrial premature beats.2.The application of metoprolol combined with Wenxin granules in the treatment of atrial tachycardia after AF ablation has a certain effect on reducing the recurrence rate of AF,but the effect is not significant.3.The application of metoprolol combined with Wenxin granules after AF ablation may have a certain effect on the improvement of postoperative atrial and ventricular size and cardiac function in patients,but there is no significant therapeutic effect.4.The combination of metoprolol and Wenxin granules in the treatment of atrial tachycardia after AF catheter ablation can reduce the side effects caused by metoprolol increment,improve safety,and have clinical value. |
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