| Objective: Frequent ventricular premature beat is a relatively common arrhythmia, if it is long-standing that can affect heart function and life quality. Radiofrequency catheter ablation is a safe and effective method of interventional therapy for frequent ventricular premature beat. But there may be a period of time of the change of inflammation and myocardial injury and high coagulation state after radiofrequency ablation. This study observe the change and duration of inflammation indicators and myocardial injury index and blood coagulation factor of patients with idiopathic ventricular premature beat after radiofrequency ablation, to observe ventricular premature beat after radiofrequency ablation indices such as inflammation, blood clotting, change law, provide the basis for research mechanism and guide the clinical medication, to observe the change law of indices of inflammation and blood clotting of ventricular premature beat after radiofrequency ablation, for researching the occur of ventricular premature beat and the mechanism of the radiofrequency ablation, providing the basis for the clinical medication of ventricular premature beat after radiofrequency ablation in the near future.Method: The subjects of the study were the hospitalized patients with idiopathic premature ventricular complexes and successfully operating radiofrequency ablation surgery as case group at the Second Hospital of He be Medical University between March 2015- January 2016,a total of 55 cases. Simultaneously, in the same period we select the patients without premature ventricular complexes and another structural heart disease,a total of 48 cases as the control group. All patients before treatment need history taking, electrocardiogram(ECG), holter, laboratory tests, physical examination and other preoperative examination. Radiofrequency ablation surgery was performed by the same surgeon,all patients unified application CARTO 3.0 three-dimensional electrophysiological ablation under the guidance of the navigation system. The control group of patients collected elbow vein blood in the early morning,the case group collected elbow vein blood before and after radiofrequency ablation surgery at 1 day,2 day,2weeks,to measure the changes of inflammatory cytokines, cardiac injury markers and coagulation factors.Data were processed with SPSS 13.0 software. When data are subject to normal distribution, continuous variables were expressed as the mean ± standard deviation, groups comparison were using Independent sample t test. Comparing different points within the same group using single factor repetitive measure analysis of variance. Count data applied frequency and percentage, using the ?2 test or Fisher's exact test. P value of <0.05 was considered statistically significant.Results: The radiofrequency ablation of all cases patients were successfully completed in the guide of Carto3.0 dimensional electrophysiological navigation system, No thromboembolic events, cardiac tamponade and other complications occurred in the subjects. No recurrence after surgery. 1 The comparison of General clinical features:The case group and the control group in the general clinical characteristics of sex, age, smoking history and hypertension, etc.(P> 0.05). 2 The myocardial injury, inflammation and blood clotting index 2.1 The case group of myocardial injury and inflammation, blood coagulation indexes before radiofrequency ablation compare with the control group.Inflammatory biomarkers: the preoperative neutrophils and lymphocytes ratio(NLR) and hypersensitive c-reactive protein( hs-CRP) of the case group were significantly higher than that of control group, the difference was statistically significant.(P < 0.05).Myocardial injury index: the preoperative troponin I(cTnI) and creatine kinase isoenzyme(CKMB) of case group compared with control group, there was no statistically significant difference(P > 0.05).Coagulation indexes: the preoperative fibrinogen and mean platelet volume of case group compared with control group, there was no statistically significant difference(P > 0.05). 2.2 The trends of inflammatory indexes of Cases patients before and after radiofrequency ablationNLR: There was significant difference in preoperative, 1 day, 2 days, 2 weeks after radiofrequency ablation surgery( P<0.05). 1 day after radiofrequency ablation surgery rose to the highest,.2 day after radiofrequency ablation surgery began to decline, but it is still higher than the preoperative(P < 0.05). Two weeks after back to normal levels(P < 0.05).hs- CRP: There was significant difference in preoperative, 1 day, 2 days, 2 weeks after radiofrequency ablation surgery( P<0.05).1 day after radiofrequency ablation surgery is higher than the preoperative(P < 0.05), 2 day after radiofrequency ablation surgery reach the peak, and it is higher than the preoperative(P < 0.05). Then it begin to decline,but 2 weeks after radiofrequency ablation surgery is still higher than before(P < 0.05). 2.3 The comparison of myocardial injury markers of the cases group patients before and after percutaneous radiofrequency ablation.CKMB:There was significant difference in preoperative, 1 day,2 days,2 weeks after radiofrequency ablation surgery( P<0.05).1 day after radiofrequency ablation surgery was higher than the preoperative.2days after radiofrequency ablation surgery reach a peak, it was significantly higher than the preoperative( P < 0.05).Then it begin to decline,2 weeks after radiofrequency ablation surgery has returned to normal.cTnI: There was significant difference in preoperative, 1 day, 2 days, 2 weeks after radiofrequency ablation surgery( P<0.05).1 day after radiofrequency ablation surgery rose to the highest,.Then it begin to decline, 2 days after radiofrequency ablation surgery has decreased significantly,but it is still high compared with the preoperative(P <0.05).2 weeks after radiofrequency ablation surgery has returned to normal,the difference was no statistically significant(P >0.05).The cTnI and CKMB of the case patients are within the normal range before Radiofrequency ablation, there were 52 people that troponin I increases more than the normal range after radiofrequency ablation, accounting for 94.56% of the total, and there were 7 people that CKMB increases more than the normal range after radiofrequency ablation, accounting for 12.72% of the total, the elevated cTnI rate was significantly higher than that of CKMB rise rate(P < 0.05). The CKMB and cTnI has returned to normal at 2 weeks after radiofrequency ablation surgery. 2.4 The comparison of Coagulation indexes of the cases group patients before and after radiofrequency ablation.Fibrinogen: There was significant difference in preoperative, 1 day, 2 days, 2 weeks after radiofrequency ablation surgery(P<0.05).1 day after radiofrequency ablation surgery slightly lower than preoperative, the difference was no statistically significant(P>0.05).Then it began to gradually increased,2days after radiofrequency ablation surgery reach a peak,it was significantly higher than the preoperative(P<0.05).Then it begin to decline,2 weeks after radiofrequency ablation surgery has returned to normal, it compared with the preoperative, the difference was no statistically significant(P >0.05).Mean platelet volume : There was no significant difference in preoperative, 1 day, 2 days, 2 weeks after radiofrequency ablation surgery(P>0.05).Conclusions:1 The hs-CRP and NLR of patients with Premature ventricular complexes were significantly higher than that of healthy controls. The level of inflammation rise after radiofrequency ablation of Premature ventricular complexes, and the most obvious is two days after surgery, then it gradually recover, it has returned to normal levels after two weeks. Suggesting the occurrence of ventricular premature beat may be associated with inflammation, and radiofrequency ablation surgery further activate the inflammation index changes, but it can be restored in the short term2 After radiofrequency ablation of Premature ventricular complexes occurred a period time of fibrinogen increasing,and the most obvious is two days after surgery, and then it gradually recover, continuing at least 2 weeks. Suggesting that there is a certain degree of high coagulation state after radiofrequency ablation, indicating that there are a degree of anticoagulant therapy after radiofrequency ablation, two days is the most important, at least 2 weeks of anticoagulant.3 The myocardial injury of cTnI and CKMB increase after radiofrequency ablation of premature ventricular complexes, further prompt the safety of radiofrequency ablation treatment of ventricular premature beat... |
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