| Background:At present,ablation surgery has been used as a class I indication for the treatment of atrial fibrillation(AF).The emergence of pulsed ablation provides a new option for the treatment of AF.However,the levels of inflammatory factors and the degree of myocardial injury after pulse ablation are still unclear.Objective:To compare the differences in myocardial injury and inflammatory factors between pulsed field ablation(PFA),radiofrequency ablation(RFA)and cryoballoon ablation(CBA)in patients with paroxysmal atrial fibrillation.Subjects and methods: Patients with paroxysmal atrial fibrillation(Atrial fibrillation,AF)who underwent ablation therapy in the Second Affiliated Hospital of Nanchang University between July 31,2022 and February 28,2023 were selected.And the patients were divided into 3 groups: pulse ablation group(P group),radiofrequency ablation group(R group)and cryoballoon group(C group).Collect basic information such as patient name,gender,age,hospital number,electrocardiogram,and cardiac color Doppler ultrasound.Before operation,1 day after operation,and 3 days after operation,blood was drawn from patients,and C reactive protein(CRP),interleukin-6(IL-6),troponin I(c Tn-I),platelet distribution width(PDW),plateletocrit(PCT),mean platelet volume(MPV),white blood cell(WBC),neutrophil percentage(NE%),neutrophil(NE),lymphocyte percentage(LY%).After 3 months of follow-up,the number of recurrences in each group was recorded.Early recurrence was defined as atrial fibrillation,atrial flutter,or atrial tachycardia that lasted more than 30 seconds recorded on the ECG or Holter within 3 months.Results:Results: A total of 51 patients with paroxysmal atrial fibrillation were included in the study,including 19 patients(37.25%)in group R,8 patients in group C(15.67%),and 24 patients in group P(47.06%).(1)The operation time in group R(243.94±71.49min)was significantly higher than that in group C(165.63±46.79min)and group P(172.54±50.33min)(P<0.05).The radiation time of group P(13.55±6.14min)was significantly lower than that of group C(33.82±21.27min)and group R(24.39±8.83min).The radiation dose of group P(118.70±85.06 m Gy)was significantly lower than that of group R(179.72± 99.48 m Gy)and group C(369.60±258.82 m Gy);(2)After operation,WBC,NE%,and NE in the three groups all increased significantly on the first day(P<0.05),and LY% decreased significantly(P<0.05),and returned to normal on the third day.There was no significant difference among three groups of WBC,NE%,NE and LY%(P>0.05);(3)CRP increased significantly after operation(P<0.05),and group P maintained a low CRP level on the first and third day after operation(P<0.05).The level of IL-6in group R decreased significantly on the 3rd day after operation(P<0.05),while the levels of IL-6 in groups C and P did not fluctuate significantly during the perioperative period.The c Tn-I in the three groups all increased significantly after operation(P<0.05).The levels of c Tn-I in groups C and P were significantly higher than those in group R(P<0.05),and there was no significant difference in c Tn-I between groups C and P.Conclusion:Compared with traditional ablation(radiofrequency ablation and cryoballoon ablation),pulsed ablation has obvious advantages in terms of operation time,radiation time,and radiation dose,and the damage to myocardial tissue is more significant.In addition,pulse ablation has the advantages of less inflammatory response and shorter duration of inflammation in the inflammatory response;but compared with traditional ablation,there is no significant difference in the early recurrence rate. |
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