Analysis Of Risk Factors Of Late Recurrence After Second Generation Cryoballoon Of Atrial Fibrillation Ablation

Objective: The study sought to assess the role of early recurrences of atrial fibrillation(ER)in predicting late recurrences(LR)in the patients with paroxysmal atrial fibrillation(PAF)and/or persistent atrial fibrillation(Ps AF)having undergone second-generation cryoballon ablation(CBA).To compare the risk of late recurrence(LR)in patients with and without early recurrence(ER),to explore the risk factors for late recurrence.Methods:A total of 135 patients with paroxysmal atrial fibrillation and/or persistent atrial fibrillation treated for the first time with second-generation cryoballoon ablation at the Department of Cardiovascular Medicine of Taizhou People’s Hospital from August2020 to December 2021 were included,and a total of 133 patients were finally included in the study due to 2 cases lost to follow-up after the procedure.General information(including age,gender,body mass index(BMI)),past history(including whether there was a history of combined smoking,coronary heart disease,hypertension,diabetes,heart failure,history of vascular disease,history of stroke,etc.),type and duration of AF,uric acid level,left atrial internal diameter(LAD),left ventricular ejection fraction(LVEF),whether cryoablation of AF+left auricular occlusion —One-stop procedure was performed.One-stop procedure,postoperative complications(including phrenic nerve injury,esophageal injury,pulmonary vein stenosis,cardiac compression,femoral artery injury,thromboembolism,etc.),postoperative medications,follow-up data including whether AF recurred and the time of recurrence,etc.According to whether atrial fibrillation recurred after surgery and the time of recurrence were divided into early recurrence group and late recurrence group,SPSS26.0 software was used for statistical analysis to compare the baseline data,whether there was any difference between early and late recurrence in patients with different types of atrial fibrillation;whether there was any statistical difference in baseline data between early and late respective recurrence group and non-recurrence group,and multi-factor COX regression analysis was performed for late recurrence group to assess the effect of early recurrence of atrial fibrillation on late recurrence was assessed.Results: Among 133 patients,73(54.9%)patients were male,with a mean age of67.4±8.3 years,24(18.0%)were early recurrence patients,40(30.1%)were late recurrence patients,and the overall success rate of AF cryoablation at 1 year was 69.9%;among them,late recurrence occurred in 14(58.3%)of 24 early recurrence patients and14(23.9%)of 109 non-ER patients.The long duration of atrial fibrillation,enlarged left atrial internal diameter,diabetes mellitus,and early recurrence were independent risk factors for late recurrences after cryoablation of atrial fibrillation,and the risk of late recurrences after cryoablation of atrial fibrillation was 3.84 times higher in patients with early recurrence than in patients without early recurrence.Multivariate Cox regression analysis showed that early recurrence during the blank period was independently associated with an increased risk of late recurrence(HR 3.84,95% CI 1.76-8.37,P=0.001).Conclusion: Early recurrence of atrial fibrillation after second-generation cryoballoon ablation is an independent risk factor for late recurrence,and the long duration of atrial fibrillation,enlarged left atrial internal diameter,and diabetes mellitus are also independent risk factors predicting late recurrence after atrial fibrillation ablation.