The Effect Of The Vagal Denervation During The Operation Of Circumferential Pulmonary Vein Ablation On Therapeutic For Paroxysmal Atrial Fibrillation

Objective To observe the effect of the treatment in paroxysmal atrial fibrillation (PAF) patients occured vagal denervation (VD) and ablation of fragmented potential during the operation of circumferential pulmonary vein ablation (CPVA). Methods:89 cases were accepted the treatment of CPVA, the ablation endpoint was electrical isolation of pulmonary veins. The cases occured VD and ablation of the fragme- nted potential mapped in the operation were regarded as a positive group, the others as a negative group. The dates of two groups including heart rate variability (HRV)(including Mini HR,Max HR,Mean HR,SDNN,rMSSD), left atrial diameter (LAD) and left ventricular ejection fraction (LVEF) were observed and compar- ed during the preoperative, postoperative of 1th day,3th month and 6th month. Patients keeping sinus heart rhythm in 3th month without atrial arrhythmia not taking antarrhythmia drags would be looked as success. Results:89 cases all achieved the endpoint. 64 cases maintained sinus rhythm after 3 months without atrial arrhythmias including 23 cases of positive group and 41 of negative. The success ratio of positive group was higher than negative (85.19% VS 66.13%, P <0.05). HRV of positive group in postoperative of 6th month were all reduced compared the preoperative(P <0.05), the changes of negative group were no significant differences (P> 0.05), LVEF of the two groups were all raised and the LAD reduced (P <0.05). The values of LAD reduced were higher for positive than negative (P <0.05), of EF raised were no significant difference (P> 0.05). Conclusion:With the occurrence of VD and ablation of fragmented potential during the operation of CPVA for the treatment of PAF patients there may be accompanied by an increasing of success rate, growed down acromegalic LAD values notably, and did not reduce EF values.