Study Of Radiofrequency Catheter Ablation Optimization On Patients With Persistent Atrial Fibrillation

Objective:This study was designed to investigate the circumferential pulmonary vein isolation(CPVI)and add linear ablation on the basis of circumferential pulmonary vein isolation(CPVA+Lines),and reflects the difference between the two methods by the comparison on operation time,X-ray exposure,immediate success rate and long-term success rate,aim to see which is the better one and whether It is necessary to adopt a second surgical procedure.Method:Select 63 cases of patients with persistent atrial fibrillation from 2010.12 to2014.12 in the cardiovascular department of Yijishan hospital,after exclusion of contraindications,take Circumferential pulmonary vein isolation for all the 63 patients,then a Left atrial voltage mapping will be followed.According to different voltages,the patients were divided into two groups: in which CPVI group(N = 27),CPVI + Lines group(N = 36);all the patients were followed up for recurrence and complications within the first 3 months and the 12 months: compare 2 groups in operative time,X-ray exposure,the successful rate of immediate,long-term success rate,early relapse rate,late recurrence rate differences,to see if there are differences between them.Another 117 cases of paroxysmal atrial fibrillation was selected,treated with CPVI,then compared its operation time,X-ray exposure,immediate success rate,long-term success rates with persistent AF CPVI group,to see if there are differences between them.Results: Outcomes of CPVI group and CPVI+Lines group : operation time[(131.22±18.80)min(141.03±18.58)min],it had statistical significant differences(P=0.043<0.05),X-ray exposure amount [(2517.79±566.03)m Gy(2611.28±526.82)m Gy],both not statistically significant(P=0.502> 0.05);immediate success rate in both groups(92.59% 97.20%),no statistical significance(P=0.798>0.05);long-term success rate(66.67% 72.22%),no statistically significant difference(P= 0.664> 0.05);CPVI group got 9 cases of recurrence:5 cases of early recurrence,4cases of late recurrence,CPVI + Lines group got 10 cases of recurrence:2 cases of early recurrence and 8 cases of late recurrence,early relapse rate(18.52% 5.56%),late recurrence rate(14.81% 22.22%),no significant difference(P>0.05).Compared with the same period 117 cases of paroxysmal atrial fibrillation : immediate success rate(92.59% 99.14%),no statistical significant difference(P=0.961>0.05),long-term success rate(66.67% 83.76%),was statistically significant(P = 0.043 <0.05).Conclusion: Compared with CPVI+Lines surgical way,CPVI surgical have less procedures and shorter operative time on the treatment of persistent atrial fibrillation.The immediate surgical success rate,long-term success rate,early relapse rate and late recurrence rate of two groups had no significant difference;After confirming no low voltage on the posterior wall of the left atrium,persistent atrial fibrillation can be treated by simple pulmonary vein isolation,and additional ablation steps is unnecessary.