Comparison Of Clinical Effects Of Cryoablation And Radiofrequency Ablation In The Treatment Of Paroxysmal Atrial Fibrillation

Objective:This study aims to compare the clinical effects of cryoablation and radiofrequency ablation in the treatment of paroxysmal atrial fibrillation,and to analyze the risk factors for recurrence after paroxysmal atrial fibrillation ablation.Methods:This study retrospectively selects 169 patients with paroxysmal atrial fibrillation who received radiofrequency ablation or cryoablation in the First Hospital of Jilin University from January 2019 to December 2019.Through filtering,107 patients are enrolled in this study,of which54 are in the radiofrequency ablation group and 53 are in the cryoablation group.All patients in this study were treated with class I and(or)class III antiarrhythmic drugs and received atrial fibrillation ablation for the first time.According to the 12-months following-up result after ablation,patients are divided into recurrence group and non-recurrence group.A single factor analysis is performed on the two groups of patients,and the statistically significant clinical data in the single factor analysis will be enrolled in the binary multivariate logistic regression analysis.The receiver operating characteristic curve is used to analyze the predictive value of independent risk factors for recurrence of paroxysmal atrial fibrillation ablation.Results:1.Baseline data: 54 in the radiofrequency ablation group and 53 in the cryoablation group.The two groups have no significant differences in age,gender,BMI,disease time,CHA2DS2-VASc score,smoking history,drinking history,hypertension,diabetes,EF,LAD and other baseline data(P>0.05).2.Procedure time parameters: Procedure time of the radiofrequency ablation group is significantly longer than that of the cryoablation group(169.8 ±47.9))min VS(100.4± 19.2)min,(P<0.001);Exposure time of the radiofrequency ablation group is significantly shorter than that of the cryoablation group(16.5±1.8)min VS(24.5±6.1)min,(P<0.001).3.Recurrence rate: The postoperative recurrence rate of the radiofrequency ablation group and the cryoablation group are similar.The 6-month and 12-month recurrence rates in the radiofrequency ablation group are22.2% and 27.8%,and the cryoablation group are 22.6% and 26.4%respectively.there was no statistically significant difference between the two groups(P>0.05).4.Complications:The overall complication of the radiofrequency ablation group was 3.7% and that in the cryoablation group was 5.7%.There was no statistically significant difference between the two groups(P>0.05).5.Risk factors for recurrence after paroxysmal atrial fibrillation ablation: The univariate analysis of recurrence risks factors after paroxysmal atrial fibrillation ablation shows that LAD of the recurrence group is higher than those of the non-recurrence group,and the difference between the two groups is statistically significant(P<0.005);Binary multivariate logistic regression analysis showed that LAD is an independent risk factor for recurrence after paroxysmal atrial fibrillation ablation(OR:1.4;P<0.001;95%CI 1.152-1.618);Receiver operating characteristic curve showed area under the curve is 0.736(P<0.001,95%CI:0.642-0.830).When the cut-off value is 39.5mm,the value of predicting recurrence after paroxysmal atrial fibrillation ablation is the best.the sensitivity is 82%,and the specificity is 56%.Conclusion:1.Radiofrequency ablation is longer than cryoablation in the procedure time,but shorter in the exposure time;2.The postoperative recurrence rate and overall complication rate of radiofrequency ablation and cryoablation are equivalent;3.The left atrium diameter is an independent risk factor for recurrence after paroxysmal atrial fibrillation ablation.Larger the left atrium diameter can cause higher risk of recurrence.