Analysis Of Risk Factors For Recurrence Of Atrial Fibrillation After Radiofrequency Ablation Of Atrial Fibrillation In Patients Undergoing Heart Valve Surgery

Objective To analyze the risk factors of atrial fibrillation(AF)recurrence after radiofrequency ablation of AF in patients undergoing heart valve surgery,in order to provide a reference for the prevention of postoperative AF recurrence in clinical patients.Methods From January 2011 to December 2017,179 patients who underwent valvular surgery and cardiopulmonary atrial fibrillation ablation during cardiac vascular surgery in general hospital of ning xia medical university were selected as the research subjects for retrospective analysis.All patients underwent heart valve surgery and performed atrial fibrillation radiofrequency ablation.They were divided into recurrence group and normal group based on whether AF recurred 3 months after surgery.The hospital HIS system was used to obtain the index data of the two groups of subjects:(1)preoperative clinical data: age,gender,body mass index(BMI),course of disease,comorbidities(coronary heart disease,hypertension,diabetes,obsolete cerebral infarction),cardiac function Classification(NYHA classification),smoking history,drinking history,atrial fibrillation type,left and right atrial diameter,left ventricular ejection fraction,anti-"O",ESR,rheumatoid factor(RF),high-sensitivity C-reactive protein(hs-CRP);(2)Intraoperative data: extracorporeal circulation time,aortic occlusion time,co-operative procedures(aortic valve replacement,mitral valve replacement,tricuspid angioplasty,atrial defect correction,coronary bypass,left atrial appendage Treatment);(3)Postoperative indicators: early postoperative atrial fibrillation,amiodarone use,and beta-blocker use.Univariate and binary logistic regression analysis were performed in order to determine the independent risk factors for AF recurrence in patients undergoing cardiac valve radiofrequency ablation during the same period.Results(1)Among the 179 patients,82 had recurrence after surgery,and the recurrence rate was 45.81%.(2)The course of disease,type of AF,combined hypertension,left atrial anterior-posterior diameter,left atrial appendage treatment rate,early postoperative AF rate,and amiodarone use were significantly different between the two groups.Among them,the course of disease,the proportion of patients with nonparoxysmal atrial fibrillation,left atrial anterior-posterior diameter,the proportion of patients with hypertension,the rate of early postoperative atrial fibrillation,and the rate of amiodarone use were higher than those in the normal group(P <0.05)The left atrial appendage treatment rate was lower than that in the normal group(P <0.05).(3)Logistic regression analysis confirmed that there was a significant correlation between left atrial anterior-posterior diameter,atrial fibrillation type,left atrial appendage treatment,early postoperative AF and AF recurrence(P <0.05).Nonparoxysmal atrial fibrillation,left atrial anterior-posterior diameter,and early postoperative atrial fibrillation are independent risk factors.left atrial appendage treatment was an independent protective factor.Conclusion The AF type,left atrial anterior-posterior diameter,left atrial appendage treatment,and early postoperative atrial fibrillation are independent influencing factors of AF after AF Ablation in patients undergoing heart valve surgery.Nonparoxysmal atrial fibrillation,larger left atrial anterior-posterior diameter,and early postoperative AF are independent risk factors that increase the risk of recurrence.The left atrial appendage treatment are independent protective factors that can prevent recurrence of AF after surgery.