Study Of Recurrence Factors Of Paroxysmal Atrial Fibrillation After Catheter Ablation

objective To investigate the factors peredicting the recurrence of paroxysmal atrial fibrillation(PAF) after catheter ablation.Methods In this study,117 patients with PAF who underwent radiofrequency catheter ablation guided by 3-dimensional mapping system at a single medical center from June 2010 to Ocotober 2013 were errolled.The clinical datum before catheter ablation were recorded, After a follow-up of 24.6±2.91(6-46)months, divide them into recurrence group and non-recurrence group according to the recurrence of atrial fibrillation, and normal group, elevated group, high group according to homocysteine levels. Observe the recurrence rate of patients in different HCY groups 6 months, 12 months and more than 12 months after surgery. Through the analysis of preoperative clinical data, univariate and multivariate analysis are carried out to determinate the factors predicting recurrence of PAF.Results A total of 117 patients completed the postoperative follow-up,and there were 43(36.75%) recurrence.Univariate analysis showed that body mass index(BMI), hypertension, duration of atrial fibrillation,left atrial diameter(LAD), high density lipoprotein cholesterol(HDL-C), Uric acid(UA), plasma homocysteine(HCY) after ablation were related to recurrence. recurrence rates of HCY high group and elevated group in recurrence group are higher than that of non-recurrence group. The differences of HCY level between groups are of statistical significance(p<0.01). All of the atrial fibrillation recurrences of high groups 6 months, 12 months and more than 12 months after surgery are higher than that of normal groups(p<0.05). The atrial fibrillation recurrences of high groups more than 12 months after surgery are higher than that of normal groups(p<0.05), the differences between elevated group and normal group are not statistical meaningful. The correlation analysis of HCY level and recurrence rate of paroxysmal atrial fibrillation demonstrates that HCY level and paroxysmal atrial fibrillation are positively related(r=0.407,p<0.05). Multivariate logistic regressions analysis show that duration of atrial fibrillation(P<0.0001; OR:1.031; 95%CI:1.016-1.047), HDL-C(P=0.028; OR:0.044; 95%CI:0.003-0.711), UA(P=0.004; OR:1.009;95%CI:1.003-1.015), HCY(P=0.003;OR:1.212;95%CI:1.070-1.372) are the independent predictors of recurrence.Conclusion duration of atrial fibrillation, HDL-C,UA,HCY are the independent predictors of recurrence of PAF after catheter ablation.