The Analysis Of Prognosis Between Pulmonary Arterial Hypertension And Atrial Fibrillation After Catheter Ablation

Objective:To investigate the influence of pulmonary arterial hypertension (PAH)on recurrences of patients with atrial fibrillation (AF)after radiofrequency catheter ablation, and analyze the pulmonary arterial pressure and cardiac structure changes after ablation in atrial fibrillation with pulmonary hypertension.Methods:A total of 80 AF patients were studied, included 40 ones with PAH and the others were not. All patients received the first time atrial fibrillation radiofrequency ablation, with complete treatment of data and regular follow-up visit, from Sep 2009 to March 2015. The median follow-up of PAH group was 13.98±11.32 months, and control group 14.18±12.39 months. The electrocardiogram, dynamic electrocardiogram, ultrasonic cardiogramand other clinical examinations were followed in all patients. PAH and related clinical characters were evaluated by the single factor and Logistic regression analysis.Results:The average pulmonary arterial pressure of PAH group was 39.85±5.34mmHg reported by ultrasonic cardiogram. It was similar in basic clinical characters (p>0.05) between PAH group and control group in terms of age, gender, type of AF, AF duration, type 2 mellitus diabetes, structural heart diseases (coronary heart disease, hypertensive cardiopathy, atrial septal defect and hypertrophic cardiomyopathy), subclinical thyroid disease, dyslipidemia, ejection fraction, rhythm. Right atrial diameter and valvular insufficiency were significant difference between the two groups (p<0.01).There was no significant difference in early and long-term recurrence (p>0.05) in PAH group when compare with control group after ablation. The single factor analysis showed that type 2 mellitus diabetes (p=0.034), moderate to severe valvular inadequacy (p=0.026), postoperative complications (p=0.015) and early recurrence (p<0.01) had significant effect on long-term recurrence after AF ablation. However, mild PAH (p=0.699) did not show influence on long-term recurrence of AF after radiofrequency ablation. Logistic regression analysis showed that moderate to severe valvular inadequacy (p=0.020) and early recurrence (p<0.01) were independently related to AF long-term recurrence. Compare to preoperative ultrasonic cardiogram changes, the difference was significant (p<0.05) in left atrial anterioposterior diameter, right atrial transverse diameter and valvular inadequacy in postoperative PAH group. And pulmonary arterial pressure of 23 patients in PAH group went down to normal after ablation (p<0.01)Conclusion:The results of the study showed that mild pulmonary arterial hypertension does not show influence on long-term recurrence of AF after radiofrequency ablation. Pulmonary arterial pressure and cardiac structure changes are significantly improved after radiofrequency ablation in AF patients with mild pulmonary arterial hypertension.