Density Of Ablation Points May Predict Freedom From Atrial Fibrillation After Ablation Using Remote Magnetic Navigation

Background In the past decade,circumferential ablation of pulmonary veins has become the firstline therapy strategies to help patients get rid of symptomatic AF.The procedure was manipulated manually along with prolonged procedure and fluoroscopy times.Since 2002,remote magnetic navigation (RMN) has been an accepted therapeutic alternative for many types of arrhythmias,especially in patients with atrial fibrillation (AF) resistant to antiarrhythmic medications.Comparing to manual catheter navigation (MCN),RMN shows similar procedural success rates and possibly better safety outcomes comparing to MCN in patients with AF.But there are limited clinical database on whether the density of ablation points predicting freedom from atrial fibrillation using remote magnetic navigation for ablation of atrial fibrillation.Methods There were 86 patients enrolled in the research which consisting 52 paroxymal atrial fibrillation patients and 34 persistent atrial fibrillation patients.After one year follow up,we compared the gender, age, number of ablation points,density of ablation points,complications, left atrium diameter, left atrial volume, left ventricular ejection fraction, hypertension, diabetes and coronary heart disease between paroxymal atrial fibrillation patients and persistent atrial fibrillation patients to reveal if there existing signification. The density of ablation points was estimated by ADR (number of ablation points/left atrium diameter) and AVR(number of ablation points/ (?))Results In paroxymal atrial fibrillation patients,there was no significance (P=0.755)on the number of ablation points between the relieved(120.21 ±33.95) and unrelieved(123.38 ±22.70)patients;there was no significance (P=0.904)on the ablation points to diameter ratio between the relieved (32.34 ±10.09) and unrelieved (31.98 ±6.21) patients;there was no significance (P=0.995) on the ablation points to volume ratio between the relieved (26.42 ±7.29) and unrelieved (26.43 ±3.99) patients.In persistent atrial fibrillation patients,there was no significance (P=0.142) on the number of ablation points between the relieved (138.21 ±34.35) and unrelieved (119.10 ±32.11) patients;there was significance (P=0.045) on the ablation points to diameter ratio between the relieved (33.34 ±9.04) and unrelieved (26.62 ±7.15) patients;there was significance (P=0.032) on the ablation points to volume ratio between the relieved (27.62 ±7.11) and unrelieved (22.01 ±5.28) patients.According to paroxymal atrial fibrillation patients,the univariate logistic regression model showed that there was no correlation between ADR (OR,1.044,95% CI:0.938-1.076), AVR(OR,1.000,95% CI:0.938-1.101)and the recovery rate of AF patients.The multivariate logistic regression model showed that there was no correlation between ADR (OR,1.034,95% CI:0.957-1.116), AVR(OR,1.030,95% CI:0.927-1.144)and the recovery rate of AF patients.According to persistent atrial fibrillation patients,the univariate logistic regression model showed that there was no correlation between ADR(OR,1.015,95% CI:0.977-1.224)and the recovery rate of AF patients while there was significant weak correlation between AVR(OR,1.015,95% CI:0.977-1.224)and the recovery rate of AF patients.The multivariate logistic regression model showed that there was no correlation between ADR (OR,1.097,95% CI:0.981-1.227)and the recovery rate of AF patients while there was insignificant weak correlation between AVR(OR,1.138,95% CI:0.975-1.328)and the recovery rate of AF patients.Conclutions Among paroxymal atrial fibrillation patients,the research showed no increment on the recovery rate of atrial fibrillation in one year after the radiofrequency catheter ablation of atrial fibrillation achieving bidirection isolation with higher density of ablation points through circumferential isolation of the pulmonary veins.Among persistent atrial fibrillation patients,the research showed positive correlation between ablation points to volume ratio and the increment on the recovery rate of atrial fibrillation in one year after the radiofrequency catheter ablation of atrial fibrillation achieving bidirection isolation through circumferential isolation of the pulmonary veins.And the ablation points to volume ratio might be an prediction factor of the recovery rate of atrial fibrillation.