| BackgroundFor radiofrequency catheter ablation of persistent atrial fibrillation,the success rate has been low because the optimal ablation method has not been found.We have proposed a method of pulmonary vein isolation combined with high-density mapping with rotor ablation,compared with the traditional stepwise ablation strategy to explore its effectiveness.MethodWe included 252 patients and was divided into two groups.126 patients with persistent atrial fibrillation who performed rotor ablation in our center from July 2017 to December 2018 were included in the rotor ablation group.Then we matched 126 patients with persistent atrial fibrillation who underwent stepwise ablation during the same period and were included in the traditional surgical group.ResultsProcedural time and fluoroscopy time of the two groups were not significantly different(Procedural time 201.70.4±25.7min vs 204.6±28.9min,p=0.455;fluoroscopy time7.0±1.2min vs 7.2±1.4min,p=0.519),but the radiofrequency delivery time of the rotor ablation group was shorter(69.7±7.0min vs 80.3±8.9min,p< 0.01).Intraoperative atrial fibrillation termination rate was significantly higher in the rotor ablation group than in the traditional surgical group(71.4% vs 14.3%,p<0.01).120 patients were measured for dispersion mapping.A total of 487 high-dispersion areas were found.The most widely distributed areas were roof,bottom,and the inferoposterior wall.During a follow-up period of 423±182 days,the recurrence rate of the rotor ablation group was significantly lower than that of the traditional surgery group(21.4% vs 38.9%,p=0.003<0.01),and the recurrence rate of AF / AT recurrence was higher in the rotor ablation group(62.9% vs 32.7%).ConclusionFor patients with persistent atrial fibrillation undergoing radiofrequency catheter ablation,the strategy of dispersion-guided rotor ablation in conjunction with CPVI is superior to the traditional stepwise ablation strategy in terms of effectiveness,individualization,and accuracy. |
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