| Objective: To evaluate the safety and effectiveness of left atrial BOX-radiofrequency ablation guided by ablation index(AI)with persistent atrial fibrillation by analysing the intraoperative parameters,postoperative complications and recurrence rate.Methods: Patients with persistent atrial fibrillation who underwent radiofrequency catheter ablation at the Department of Cardiology in our hospital from May 2019 to May 2020 were selected retrospectively,and divided into the AI Group and the control group.The operation method was bilateral pulmonary vein isolation + left atrial top line isolation + left atrial posterior wall line isolation(left atrial Box radiofrequency ablation).Patients in the AI group were treated with left atrial BOX-radiofrequency ablation,while patients in the control group were treated with conventional left atrial BOX-radiofrequency.The total discharge duration,ablation discharge times,ablation time at each point,the number of cases requiring additional ablation,the early recurrence rate in 3 months,the recurrence rate in six months and the related complications(pericardial tamponade,left atrial esophageal fistula)of the two groups were statistically analyzed and compared.Results:(1)A total of 52 patients were included,36 patients in the AI group and 16 patients in the control group.Compared with the control group,the total discharge time of AF radiofrequency ablation in the AI group was less(42.5 ± 7.0 m versus 57.5± 6.7 m,P < 0.001).The discharge time of each ablation point in the AI Group was less than that in the control group(21.6 ± 1.3 s versus 31.8 ± 7.2 s,P <0.001).(2)The frequency of radiofrequency ablation in the AI group was similar with the control group(118.3 ± 18.2 versus 112.6 ± 24.0,P=0.349),and there was no significant difference in the number of cases requiring supplementary ablation between the AI group and the control group [18(50%)versus 5(31.3%),P=0.209].(3)There was no early recurrence in the AI group and the control group in 3 months.There was no significant difference in 6-month recurrence between the AI group and the control group [1(3.8%)versus 1(6.3%),P=0.548)].There were no complications such as pericardial tamponade and left atrial esophageal fistula in the two groups.Conclusion: Compared with conventional catheter radiofrequency ablation,AI guided left atrial BOX-radiofrequency ablation can significantly reduce the discharge time,and do not increase the probability of postoperative recurrence and related complications.AI guided left atrial BOX-radiofrequency ablation is more safe and effective,and is worthy of promotion and application in radiofrequency ablation of persistent atrial fibrillation. |
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