Risk Factors For Atrial Fibrillation Recurrence After Radiofrequency Catheter Ablation In Patients With Atrial Remodeling

Objectives:Atrial fibrillation is closely related to atrial remodeling,and make cause and effect to each other.Several studies suggested that atrial remodeling had specific pathophysiology and prognosis.Our study is to explore the risk factors for atrial fibrillation recurrence after radiofrequency catheter ablation,as well as the risk factors for recurrence in atrial fibrillation patients complicated with atrial remodeling.Methods:Ninety-three patients who had been admitted to the first ward of department of cardiology for catheter ablation at the first affiliated hospital of Nanjing medical university from 2018 to 2020 were recruited retrospectively,atrial remodeling was found in 68 of them.We collected baseline characteristics include demography,underlying diseases,parameters of echocardiography,laboratory test,and parameters of the postoperative electrocardiogram.All patients were follow-up regularly for 12 months.Results:Atrial fibrillation recurrence occurred in 19 patients who were then divided into the atrial fibrillation recurrence group,the rest of the patients were divided into the sinus rhythm maintenance group.Age,postoperative average heart rate for 24 hours,terminal force of P wave in lead V1(Ptf V1),and early recurrence were significantly different between the two groups.Multiple logistic regression showed that early recurrence(OR 9.13,95% CI 2.23-37.40,p<0.05),an increased postoperative average heart rate for 24 hours(OR 1.06,95% CI 1.01-1.12,p<0.05),and abnormal Ptf V1(OR 4.52,95% CI 1.04-19.71,p<0.05)were independent risk factors for atrial fibrillation recurrence.Atrial remodeling occurred in 68 patients who were divided into 2 groups according to the above criteria.Neutrophil count,postoperative average heart rate for 24 hours,and early recurrence were significantly different between the two groups.Multiple logistic regression showed that early recurrence(OR 16.33,95% CI 2.90-92.08,p<0.05),and an increased postoperative average heart rate for 24hours(OR 1.08,95% CI 1.01-1.1,p<0.05)were independent risk factors for atrial fibrillation recurrence.Conclusions:Early recurrence,an increased postoperative average heart rate for 24 hours,and abnormal Ptf V1 are independent risk factors for atrial fibrillation recurrence after radiofrequency catheter ablation.In patients with atrial remodeling,risk factors include early recurrence,and an increased postoperative average heart rate for 24 hours.