Analysis Of Predictors For Atrial Fibrillation Recurrence After Radio-frequency Catheter Ablation

Background:The epidemiologic study of AF demonstrated that the morbidity of AF is0.77-2.8%in China. Recently, the AF burden, morbidity and dead rate was increasingby years. It`s important to restore sinus rhythm as soon as possible for the prognosisof AF. The treatment position of radio-frequency catheter ablation(RFCA) hadincreased to be the first line of treatment no matter whether the type of AF wasparoxysmal or persistent in recent years. However, the recurrent rate was always high.Therefore, the study for the predictors of AF recurrence was emphasized.Objectives：The purpose of this study was to determine the predictors of early recurrence andlate recurrence of AF(ERAF,LRAF) after RFCA through the retrospective study. Wecould give a guidance about how to choose a suitable treatment.Methods:We assessed97consecutive patients with paroxysmal or persistent AF(29female,mean age57.31±11years) undergoing percutaneous RF catheter ablation from March2012to March2014in Vasculocardiology Department of No.1hospital of JiLinUniversity. Collect the type of AF. Self-reported height and weight were used toderive Body Mass Index (BMI). NT－proBNP, blood lipid and FBG (fastingblood-glucose) was measured before RFCA. MetS and obesity was diagnosed by thestandard issued from NCEP-ATPⅢ. LAV was calculated on the basis of computedtomography images at baseline or the electroanatomic mapping. We could get the LAD and LVEF from the echocardiography. Record the situation about the use ofAAD. After1year follow-up, we collected the patients`quantity of ERAF and LRAF.Results：The retrospective analysis of97consecutive patients has been done. The basicinformation did not have any discrepancy like age and gender(P>0.05). During afollow-up, there were43late recurrences. ERAF occurred in43patients,29patientsof whom came up LRAF. The type of AF, the use of AAD after RF, LAV, LVEF andMetS were not related to ERAF(P>0.05). NT-proBNP and BMI was the predictors ofERAF(P<0.05). What`s more, they were the independent factors to ERAF(NT-proBNP:HR1.001,95%CI1.000-1.002, P=0.009; BMI:HR1.252,95%CI1.072-1.463, P=0.005). In both LRAF group and non-LRAF group, the type of AF,the use of AAD after RF and LVEF had no discrepancy in statistics(P>0.05). Thereexisted differences between two groups at the project of LAV（P=0.006）、LAD（P=0.000）、NT-proBNP（P<0.001）、BMI（P<0.001）and MetS（P=0.002）.Whatis more that LAV (HR1.029,95%CI1.003–1.055, P=0.029）、NT-proBNP（HR1.001,95%CI1.000–1.003, P=0.033）、BMI（HR3.161,95%CI1.822–5.487,P<0.001）were the independent predictors of the late recurrent of AF.Conclusion：The independent predictors of ERAF after RFCA are NT-proBNP and BMI;LAV，NT-proBNP，BMI，MetS and LRAF are related to LRAF. Among them,NT-proBNP, BMI and LAV are the independent factors of LRAF.