Catheter Radiofrequency Ablation Influence Ischemic Stroke Of Atrial Fibrillation Of High Risk Of Thromboembolism

Objective: To evaluate whether radiofrequency ablation can effectively reduce therisk of ischemic stroke and whether we can stop the continuous anticoagulation aftersuccess radiofrequency ablation of atrial fibrillation.Method: From January2002to September2010，three hundred and ninety-fivepatients（CHA2DS2-VASc score≥2scores）were divided into three groups.Group A，123cases（accepted radiofrequency catheter ablation and the operation is successful）includes male61cases(49percent),64±7years old, left atrial internal diameter is39±4mm, left ventricular internal diameter is47.2±4.1mm, LVEF is56.7±2.1percent,CHA2DS2-VASc score is2.8±0.7scores，Hypertension83cases(68percent), Diadetes20cases(16.3percent), stroke0case, congestive heart failure3cases(2.4percent);Group B，72cases(accepted radiofrequency catheter ablation and the operation is fail),incudes male29cases(40percent),64±3years old, Left atrial internal diameter is39.1±4.2mm, left ventricular internal diameter is47.3±4mm, LVEF is56.7±2.2percent,CHA2DS2-VASc score is2.8±0.7scores, Hypertension53cases(73percent), Diadetes11cases(15.3percent), stroke0case, congestive heart failure2cases(2.8percent);Group C，201cases (no atrial fibrillation) incuding male78cases(39percent),66±9years old, Left atrial internal diameter is37.1±4mm, left ventricular internal diameter is45±4.2mm, LVEF is56.7±2percent, CHA2DS2-VASc score is2.3±0.4scores,Hypertension155cases(77percent), Diadetes42cases(21percent),stroke0case,congestive heart failure8cases(4percent);No follow-up is20cases.Thepatients who accepted radiofrequency catheter ablation had frequent and obvioussymptoms, the therapy of Anti-arrhythmic drug was invalid, can’t tolerate the Sideeffects of Anti-arrhythmic drug, the patients and family requestded or agreed with radiofrequency ablation.All patients were aged between40and80.Result:1.Both the stroke incidents (1case in group A and5cases in group B,P=0.024) and both the TIA incidents (2cases in group A and2cases in group B,P=0.33).2.Both the stroke incidents (1cases in group A and2cases in group C), butboth the TIA incidents (2cases in group A and4cases in group),P>0.05.Conclusion:1.The atrial fibrillation with high risk of thromboembolism who havehad successful radiofrequency ablation can stop oral warfarin anticoagulation.2.Successful radiofrequency ablation can effectively reduce the incidence ofpostoperative cerebral embolism events.