Clinical Characteristics And Efficacy Analysis Of Radiofrequency Ablation Of Ventricular Arrhythmias In Patients With Coronary Heart Disease

Background: Ventricular arrhythmia is one of the main complications of coronary heart disease(CHD).Radiofrequency ablation is still one of the main strategies in the treatment of ventricular arrhythmias.At present,there are still few studies on the clinical characteristics of CHD complicated with ventricular arrhythmia.This study analyzed the clinical characteristics and ablation efficacy of 1156 patients with ventricular arrhythmia undergoing radiofrequency ablation,which provides certain guidance for the clinical diagnosis and treatment of CHD complicated with ventricular arrhythmia.Methods: 1156 patients of ventricular arrhythmia who admitted to Jiangsu Provincial People's Hospital for radiofrequency ablation from July 2009 to December2017 were selected.These subjects were aged between 23 and 85 years old,including537 males and 619 females,and were divided into CHD group with ventricular arrhythmia and non-CHD group with ventricular arrhythmia according to the presence or absence of CHD.Collecting the basic data and clinically relevant information of two groups,we summarize and analyze the two groups of patients in the history of smoking and drinking,sex,age,BMI,the combined clinical diseases(hypertension,hyperlipidemia and diabetes),heart structure,the types of ventricular arrhythmia,ventricular arrhythmia origin and success rate of surgery and other clinical features.At the same time,we compared the efficacy of radiofrequency ablation between the two groups and the factors influencing the success ofradiofrequency ablation in the group of CHD with ventricular arrhythmia.Results: Data analysis showed that the age of CHD group with ventricular arrhythmia ranged from 41 to 85 years old,with an average age of 63.01±9.66 years.The age of the non-CHD group was from 23 to 80 years old,with an average age of47.43±11.55 years.The age of the CHD group was significantly increased compared with that of the non-CHD group.The proportion of men in the CHD group with ventricular arrhythmia was significantly higher than that in the non-CHD group with ventricular arrhythmia(71.7% and 43.9%,respectively)(p<0.001).BMI of CHD group was significantly higher than that of non-CHD group.The proportion of obese patients in CHD with ventricular arrhythmia group(42.5%)was significantly higher than that in non-CHD with ventricular arrhythmia group(32.1%).In addition,we found that the proportion of hypertension,diabetes,hyperlipidemia and smoking in CHD group with ventricular arrhythmia was significantly higher than that in non-CHD group with ventricular arrhythmia.Compared with the non-CHD group,the proportion of ventricular tachycardia increased in the CHD group with ventricular arrhythmia,while the proportion of ventricular presystolic contraction decreased.In addition,there were 73 cases of patients with left ventricular origin in the CHD group(68.9%)and 194 cases of patients with left ventricular origin in the non-CHD group,(18.5%).There were significant differences between the two groups.The left ventricular ejection fraction(LVEF)of the CHD group was significantly decreased compared with that of the non-CHD group,while the left ventricular end-diastolic dimension(LVDd)was significantly increased.The success rate of radiofrequency ablation was 43.40% in the CHD group and 81.5% in the non-CHD group,and significantly increased in the non-CHD group.Finally,we analyzed the factors influencing the success of radiofrequency ablation in CHD group with ventricular arrhythmia,and found that there were significant differences between the successfulgroup and the unsuccessful group in diabetes,hypertension,left ventricular diastolic end diameter and LVEF.Conclusions: The proportion of age,sex,BMI,hypertension,diabetes,hyperlipidemia and smoking in CHD patients with ventricular arrhythmia was significantly higher than that in non-CHD patients with ventricular arrhythmia.In addition,the success rate of radiofrequency ablation in CHD patients with ventricular arrhythmia was significantly lower than that in non-CHD patients.Among them,diabetes mellitus,hypertension,LVDd and LVEF are the main factors affecting the success rate of radiofrequency ablation of CHD with ventricular arrhythmia.