Circumferential Pulmonary Vein Isolation Progressive Individualized Atrial Substrate Ablation In Patients With Atrial Fibrillation Results Of Comparative Research

Objective In this study, with follow-up time and a unified definition of success formulated, circumferential pulmonary veins isolation(CPⅥ) will be compared randomly with stepwise substrate catheter ablation(SSCA), in order to achieve the following purposes:(1) both of the X-ray exposure time, operating time, recurrence rate and complications will be observed with the comparison; (2) some exploration and experience of catheter ablation of atrial fibrillation will be expected to be received.Methods 62 patients of paroxysmal atrial fibrillation were randomly divided into CPVI group (CPⅥ,n=38) and SSCA group(n=24).Three-dimensional anatomical mapping system(CARTO) was used to guide building simulated three-dimensional images of pulmonary vein and left atrium, and Lasso circular mapping catheter used to guide ablation, through these ECGs and Holter's ECGs of first.third and sixth months after the surgery, two groups will be finally compared the X-ray exposure time, operative time, recurrence rate and incidence of complications.Results (1) The X-ray exposure time of CP group and SSCA group were 33.32±6.03min and 33.42±3.93min. which no significant contrast between the two groups (P= 0.937). (2) The surgery time of both were 125.66±11.78min and 131.13±10.47min, which no significant contrast (P=0.661). (3) First month CPVI group and SSCA group were 76.3% and 75% in the rate of follow-up no-recurrence, third month the two groups were 84.2% and 75%, while sixth month the two groups were 86.8% and 62.5%, which were statistically significant (p<0.05).Conclusions (1) in the long term no-recurrence rate, CPVI is more superior than SSCA, but this needs further follow-up observation. (2) Based on the nowly mechanisms of atrial fibrillation, it will be more effective curement of atrial fibrillation as drug treatment combining catheter ablation.(3) It is relied on the breakthrough of the mechanisms of atrial fibrillation to cure atrial fibrillation more successfully.