The Study About The Clinical Efficacy Of Atrial Fibrillation With Radio Frequency Ablation Combined With Cardial Valve Surgery

Background Atrial fibrillation(AF)is the common disease which increase the motality and the incidence of stroke.At present,there is no optimal treatment to atrial fibrillation,but beyond that,we mainly based on drug therapy to promote the recovery of patients,while the prognosis was poor.In recent years,the study about radiofrequency ablation of atrial fibrillation combined with cardial valve surgery have maked progression.In recent years,more and more patients with cardial valve disease accept radiofrequency ablation combined with cardial valve surgery and it has made stage progress.So,it is very important to study the clinical efficacy with radio frequency ablation combined with cardial valve surgery.Objective It is our intent that to explore the difference of the efficiency and risk factors for recurrence using radiofrequency ablation combined cardial valve surgery or single operation to patients valvular heart disease.And so on,we provided the new evidence to this disease.Methods There were 64 patients with valvular heart disease and atrial fibrillation whose data was integrity enrolled during from December 2013 to December 2014.The patients were divided into two groups including single operation group and combination group according to different treatments.The single operation group(36 cases)received the single heart valve surgery,otherwise the combination group(28 cases)accepted radiofrequency ablation combined with cardial valve surgery.The temporary pacemaker was implanted in all of the patients after the operation.The duration of cardiopulmonary bypass and aortic clamp were observed,and the patient’s ECG(the operation day,the first month,the third month and the first year after the operation)and Ultrasonic echocardiography of the first year were collected at the same time.In addition,age,sex,AF duration,type of AF,LVEF,LVEDD,LAD of preoperation and surgery method were chosen to be analyzed by single factor Logstic regression analysis.Such practices we have done refered to ACC/AHA guidelines and based on clinical experience.Postoperative recovery were evaluated by outpatient and telephone follow-up during from the follow-up 3 months to 1 year.The SPSS17.0 statistical software was used to statistics in the end.Results There was no significant difference of complication,long-term mortality,mechanical ventilation time,the time in ICU and the period in hospital between the two groups.Recovery rates of artial fibrillation in the combination group by the day of operation and the frst month,the third month,the first year,are 92.8%、82.1%、78.6% 、75.0%respectively,Which are significantly higher than those of the single operation group which were 19.4%、16.7%、11.1%、8.3%(P<0.05).There was no significant difference in preoperative cardiac function classification between the two groups,While the cardiac function of postoperative I,II,III,IV were 53.6%、42.9%、3.5%、0% in the combination group,Which were significantly better than those of the single operation group which were 33.3%、38.9%、27.8%、0%(P<0.05).The mean diameter of the left atrium was(49.84±3.68)mm comparing with the preoperative in the combination group,which was(55.29±3.27)mm in the single operation group,thus the clinic symptoms were much more better in the combination group.By single factor analysis,the persistent AF,increased LAD,before the operation were the risk factors of recurrence.Conclusions1,The effect of radiofrequency ablation combined with cardial valve surgery was significant in the elimination rates of atrial fibrillation,alleviating patient’s heart function on during the long term follow-up.2,There was no significant difference in surgical complications and risk between the new procedure and the old one,so it is more suitable for clinical application.3,The persistent AF,increased LAD before the operation were the risk factors of recurrence.