| Objective: To observe the cardiac function,quality of life,long-term recurrence and embolism rate of patients with atrial fibrillation before and after radiofrequency ablation of pulmonary vein isolation catheter and medication by three-dimensional mapping system,and to evaluate the efficacy of radiofrequency ablation and medication for atrial fibrillation.Methods: Data of patients with atrial fibrillation admitted to the Department of Cardiology,First Affiliated Hospital of Hainan Medical College from January 2017 to October 2018 were collected.Radiofrequency ablation of circumferential pulmonary vein and drug treatment were classified according to the treatment plan.The ECG and Echocardiogram data,quality of life score,long-term recurrence and embolism rate of patients with atrial fibrillation before and after treatment were compared between the two groups.Results: Thirty patients were enrolled in the ablation group,including 16 males and 14 females,aged(65.57±15.22),27 paroxysmal atrial fibrillation and 3persistent atrial fibrillation.At the same time,50 patients with atrial fibrillation received conservative treatment with drugs were assigned to the drug group,including 28 males and 22 females,aged(66.01±16.31).Among them,45 were paroxysmal atrial fibrillation and 5 were persistent atrial fibrillation.The age,sex,type of atrial fibrillation,course of atrial fibrillation,hypertension,diabetes mellitus,embolism history,liver function(alanine aminotransferase,glutamic oxalate aminotransferase),renal function(urea,creatinine,uric acid),total cholesterol,triglyceride,low density lipoprotein,high density lipoprotein,left atrial diameter(LAD),left ventricular end-diastolic diameter(LVD),left ventricular ejection fraction(LVEF)were recorded in the two groups.There was no significant difference in LVEF(P>0.05).Cardiac structure and function: LAD of left atrial diameter before,3,6 and 12 months after ablation were(38.7±4.8)mm,(35.3±3.9)mm,(32.4±4.7)mm and(31.5±3.2)mm,respectively.The LAD of left atrium in ablation group was significantly reduced compared with that before operation(P<0.05).LVD of left ventricle in ablation group was(47.9±5.6)mm,(43.8±5.3)mm,(37.8±4.2)mm and(36.5±3.5)mm,respectively.The left ventricular ejection fraction(LVEF)of the ablation group was(49.3±5.0)%,(55.7±5.4)%,(59.2±4.9)% and(61.1 ± 5.7)%.The LVEF of the ablation group after treatment was significantly higher than that of the pre-operative group(P<0.05).LAD of left atrial diameter before operation,3 months,6 months and 12 months after operation in drug group were(38.7±4.8)mm,(37.9±4.9)mm,(38.4±3.6)mm and(38.2±3.3)mm respectively,and there was no significant difference between drug group and preoperative group(P>0.05).LVD of left atrial diameter before operation,3 months,6 months and 12 months after operation in drug group were(46.8±5.9)mm,(45.8±5.4)mm,(45.6±4.1)mm and(45.7±3.2)mm,respectively.The left ventricular ejection fraction(LVEF,%)of the drug group before operation,3 months,6 months and 12 months after operation were(48.8±4.9)%,(50.7±4.6)%,(53.2±5.0)% and(55.7±5.2)%.The LVEF of the drug group after operation was significantly higher than that before operation(P<0.05).The LAD improvement ranges of ablation group and drug group were(7.3±3.5)mm and(0.2±0.3)mm,respectively.The LAD improvement ranges of ablation group were significantly better than drug group(P<0.05).The improvement of LVD in ablation group and drug group were(12.1±4.2)mm and(1.1 ± 1.2)mm,respectively.The improvement of LVD in ablation group was significantly better than that in drug group(P<0.05).The LVEF in ablation group and drug group was significantly higher than that before operation,and the increase in ablation group was significantly higher than that in drug group(P<0.05).Quality of life:After treatment,the scores of body function,body role,body pain,general health status,vitality,social function,emotional role and mental health in ablation group were significantly higher than those in drug group,and the improvement of life quality in ablation group was significantly better than that in drug group(P<0.05).Long-term recurrence in two groups: follow-up time in ablation group was(11.7±5.2)months on average.After treatment,26 cases were successfully treated in ablation group,and the rate of maintaining sinus rhythm was 86.7%.The average follow-up time in the drug group was(11.5 +5.4)months,and 21 patients in the drug group were successful in the treatment.The rate of maintaining sinus rhythm was 42.0%.There was a significant difference in the rate of maintaining sinus rhythm between ablation group and drug group(P < 0.05).The rate of maintaining sinus rhythm in ablation group was significantly higher than that in drug group(P<0.05).Conclusion: Compared with the drug group,radiofrequency ablation of pulmonary vein isolation catheter detected by three-dimensional mapping system can significantly improve the heart structure and quality of life of patients.The recurrence rate of atrial fibrillation is low,the incidence of embolism is low.The effect of operation is remarkable. |
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