The Comparison Of Long-term Recurrence Rate Between Cardioversion And Drug Maintenance Therapy After Radiofrequency Catheter Ablation Of Atrial Fibrillation

Objective:To compare the effect of cardioversion and drug-only therapy on the late recurrence rate in patients with paroxysmal atrial fibrillation who recurred within 3 months after radiofrequency catheter ablation,and to explore the feasibility of oral drug-only therapy in the blank period after radiofrequency catheter ablation of atrial fibrillation.To guide the choice of treatment for short-term recurrence of AF after radiofrequency ablation,and provide a basis for clinical decision-making.Method:Through retrospective analysis,112 patients with paroxysmal atrial fibrillation who underwent first circumferential pulmonary vein isolation radiofrequency ablation in the Affiliated Cardiovascular Hospital of Xiamen University from May 2013 to October 2016 were divided into electrocardioversion group and drug maintenance group.The clinical data of the two groups were collected and analyzed.The effect and the recurrence rate of late AF were compared between the two groups.The difference of late AF recurrence rate between the two groups was compared.Result:112 patients with early postoperative recurrence were followed up for 12 months.Among them,52 cases were treated with electrocardioversion,14 cases with late recurrence after electrocardioversion,the long-term recurrence rate in electrocardioversion group was 26.92%(14 cases/52 total),60 cases in amiodarone maintenance group,9 cases in late recurrence group,the long-term recurrence rate in drug maintenance group was 15.00%(9 cases/60total),and the late recurrence rate in amiodarone group was significantly lower than that in the cardioversion group(x2=4.256,P<0.05).The difference was significant(P<0.05).Conclusion:The baseline values of the two groups were similar,but the long-term recurrence rates were significantly different(P<0.05).The results suggest that the size of left atrium and NT-pro BNP in electrocardioversion group increased significantly three months after operation,suggesting that electrocardioversion may lead to myocardial cell injury,and the significant increase of long-term recurrence rate may be related to myocardial hyperemia and edema,myocardial injury and electrical remodeling induced by electrocardioversion.Compared with electrocardioversion,oral medication is safe,effective,less adverse reactions,less cost and easy to promote.It is recommended for routine treatment after radiofrequency ablation of atrial fibrillation.