Comparison Of The Effectiveness And Safety Of High Power And Normal Power Radiofrequency Ablation Strategies For The Treatment Of Atrial Fibrillation In 129 Cases

Objective:The study aims to compare the immediate and long-term outcomes as well as the operational safety of high-power and normal-power radiofrequency ablation strategies for the treatment of atrial fibrillation,and to investigate the risk factors associated with the recurrence of atrial fibrillation after radiofrequency ablation procedure.Method:129 patients with atrial fibrillation treated with radiofrequency ablation at the Cardiac Electrophysiology Center of the Second Hospital of Jilin University from January 2019 to July 2021 with complete follow-up data were selected and divided into normal power group（n = 50）and high power group（n = 79）according to the power of radiofrequency ablation,and into paroxysmal atrial fibrillation group（n =82）and non-paroxysmal atrial fibrillation group（n = 47）according to the type of atrial fibrillation.Baseline data including gender,age,body mass index,type of AF,duration of disease,history of smoking,history of alcohol consumption,CHA2DS2-VASC score,HAS-BLED score,EHRA symptom classification,APPLE score,comorbid other arrhythmias,other comorbid medical diseases,anteroposterior left atrial diameter,left ventricular end-diastolic diameter,left ventricular ejection fraction rate,estimated glomerular filtration rate,blood lipids,etc.were collected.The rate of single coil isolation of left/right/bilateral pulmonary veins,time of single coil ablation of left/right pulmonary veins,time of bilateral pulmonary veins ablation,postoperative AF recurrence rate,AF recurrence-free survival rate and incidence of procedural complications were compared.The possible risk factors associated with AF recurrence after the ablation procedure in both groups were also analyzed.Results:1.Compared with normal power group,the APPLE score was higher in high power group,and the difference was statistically significant（P < 0.05）.There was no statistically significant difference in other baseline information between the two groups（P > 0.05）.2.There was no statistically significant difference in the left pulmonary vein single-circle isolation rate,right pulmonary vein single-circle isolation rate and bilateral pulmonary vein single-circle isolation rate between the two groups（P >0.05）.3.Compared with normal power group,the left pulmonary vein single-loop ablation time,right pulmonary vein single-loop ablation time and bilateral pulmonary vein ablation time were significantly shorter in high power group,and the difference was statistically significant（P < 0.001）.4.There was no statistically significant difference in the recurrence rate of atrial fibrillation during the postoperative blanking period and 3 months after operation between normal power group and high power group（P > 0.05）.5.Kaplan-Meier survival analysis showed no statistically significant difference in AF recurrence-free survival rate between high power group and normal power group（Log-rank P > 0.05）.6.In terms of safety,there was no significant difference in the incidence of operational complications between high power group and normal power group（P >0.05）.7.The results of logistic univariate and multivariate regression analysis showed that atrial fibrillation combined with atrial flutter was an independent risk factor for postoperative recurrence（OR 3.754,95%CI 1.171～12.040,P<0.05）.Conclusion:The high-power ablation strategy can effectively shorten the operation time and improve the efficiency of the procedure,benefiting any AF type without increasing the risk of procedural complications.