Risk Analysis On Postoperative Recurrence Of Atrial Fibrillation After Radiofrequency Ablation Concomitant With Valve Replacement Procedures

OBJECTIVE:Radiofrequency ablation of atrial fibrillation(AF)has been one of the effective methods for the treatment of atrial fibrillation in patients with atrial fibrillation at the same time,and there is still about 30%recurrence rate after operation.In this study,we analyzed the patient’s preoperative and intraoperative data,select the best treatment,in order to achieve the best therapeutic effect.METHODS:We collected 74 patients with heart valve disease and atrial fibrillation before and after surgery data,compiled and analyzed the data of these patients.Age,sex,body mass index(BMI),duration of atrial fibrillation,cardiac function classification,left ventricular ejection fraction(EF),preoperative left atrial diameter,preoperative hemoglobin,red blood cell distribution width(RDW),preoperative albumin,Preoperative C-reactive protein(CRP),cardiopulmonary bypass time(CPB time),aortic occlusion time(ACC time)were chosen to be analyzed by single factor analysis,whereas the factor of recurrence was screened.Identify the key factors that affect the success of the operation.RESULTS:The follow-up period was 1 year.During the follow-up period,48 patients were converted to sinus rhythm,the conversion rate was 64.86%.Univariate analysis showed that preoperative BNP levels(atrial fibrillation group 792.36 ± 544.50 pg/ml;sinus rhythm group,75.57± 11.10 pg/ml,P<0.05),preoperative hemoglobin levels(atrial fibrillation group 126.35 ± 22.52 g/L;sinus rhythm group,139.70 ± 15.29 g/L,P<0.05),Left atrial diameter(atrial fibrillation group 5.29 ± 0.59cm;sinus rhythm group 5.08 ± 0..57cm,p<0.05),preoperative CRP level(atrial fibrillation group 4.67 ± 3.27 mg/L,sinus rhythm group 3.59 ± 6.89 mg/L,P<0.050),AF duration(Atrial fibrillation group 11.29 ± 12.16years,sinus rhythm group 6.40±7.33years,P<0.05),as an independent risk factor.And gender,age,body mass index(BMI),cardiac function classification,left ventricular ejection fraction(EF),CPB time,and ACC time were not signifcantly different between the two groups.Multivariate analysis showed that preoperative left atrial diameter and preoperative CRP levels were independent risk factors for recurrence of atrial fibrillation after left ventricular radiofrequency ablation with mitral valve replacement.CONCLUSION:It is safe and feasible to treat atrial fibrillation by radiofrequency ablation,and the cure rate of atrial fibrillation is satisfactory.We can evaluate the patients during the perioperative period,select the appropriate surgical approach to patients in order to achieve better therapeutic effect.In this study,we found that patients with left atrial diameter and preoperative CRP levels in patients with postoperative recovery of sinus rhythm independent risk factors.So we regard radiofrequency ablation for atrial fibrillation combined with cardial valve surgery as safe and effective.