| Objective:Currently,there are few studies on Ablation Index(AI)in radiofrequency Ablation of atrial fibrillation.In this study,retrospective clinical trial design was adopted,which is expected to provide more evidence-based medical evidence for the effectiveness、safety and impact of this treatment strategy on recurrence types of postoperative atrial arrhythmias.Methods:Patients with AF who were hospitalized for the first time for radiofrequency ablation in 4th Hospital of Mianyang,Sichuan province from January 2017 to December 2020 and met the inclusion criteria and did not meet the exclusion criteria were selected.Treatment methods included AI-guided ablation index Group and non-AI-guided ablation index Group.In the AI group,the AI value was 500 for the front wall,450 for the top,lower wall and crest,and 350 for the back wall.Visitag showed the stability of the catheter in real time,making the distance between ablation points<4 mm and the minimum stability time≥ 5s.In addition,the ablation strategy was determined according to the intraoperative situation.SPSS23.0 statistical software was used for statistical analysis.P<0.05 indicated that the difference in results was statistically significant.Results:According to inclusion and exclusion criteria,a total of 240 cases were included in this study,including 166 cases in the AI group and 74 cases in the non-AI group.(1)There were no statistically significant differences between the two groups in age,gender,atrial fibrillation type,CHA2DS2-VASC score and HAS-BLED score,BMI,LVEF value,LA value,smoking history,preoperative heart failure,hypertension,pulmonary hypertension,diabetes,coronary heart disease and chronic obstructive pulmonary disease(P>0.05).(2)Mest and/or Mann-whitney U test results of intraoperative related time showed that there was no significant difference in fluoroscopy time between the AI group and the non-AI group(P>0.05),while the ablation time and operation time of the AI group were smaller than that of the non-AI group.The difference was statistically significant(46.3030±1.01046 min)vs.(73.4459±4.80794 min),P<0.05;(170.4182 ±4.62784 min)vs.(238.7838±38.61505 min),P<0.05);(3)According to Fisher’s accurate test results,there was no statistical significance in short-term postoperative cardiac tamponade,arteriovenous fistula,hemorrhage/hematoma,chronic arrhythmia,thromboembolism,myocardial infarction,phrenic nerve injury and esophageal fistula between the two groups(P>0.05).(4)Chi-square test results showed that the immediate postoperative success rate of AI group was 161/166(97.0%)better than that of non-AI group 66/74(89.2%),P<0.05.Moreover,the recurrence rate of atrial arrhythmia in AI group was 27/163(16.3%),still lower than that in non-AI group 20/70(27.0%),P<0.05.However,there was no statistical difference in the classification of recurrent atrial arrhythmia between the two groups immediately and 12 months after surgery(P>0.05).Conclusion:1.Ai-guided radiofrequency ablation has better immediate and long-term prognosis than traditional radiofrequency ablationendpoint,and its safety is comparable to that of traditional radiofrequency ablation.2.Ai-guided radiofrequency ablation is comparable to traditional radiofrequency ablation end-point fluoroscopy,but it can shorten the ablation and operation time.3.There was no difference in the classification of recurrent atrial arrhythmias after AI-guided radiofrequency ablation and traditional radiofrequency ablationendpoint. |
PDF Full Text Request