Treatment And Prognosis Of Fast-slow Syndrome During The Blank Period After Paroxysmal Atrial Fibrillation Ablation

Background : Catheter ablation is an effective method for treatment of atrial fibrillation,atrial fibrillation after catheter ablation can increase the incidence of atrial arrhythmia in the short term,so in this special period,it is defined as a blank period after atrial fibrillation ablation,some patients in the blank period of recurrence of atrial fibrillation,atrial tachycardia and other atrial arrhythmias,there will be a long intermittent after atrial fibrillation / atrial fibrillation termination,known as the fast-slow syndrome during the blank period,but there is nono relevant reports about its prognosis and treatment strategy.Aims:The aim of this study is to observe the incidence,clinical features,treatment and prognosis of the fast-slow syndrome during the blank period after paroxysmal atrial fibrillation ablation.Methods: From January 2002 to June 2016,the patients were treated with paroxysmal atrial fibrillation ablation in the First Affiliated Hospital of Dalian Medical University,and 30 patients(group A)with the fast-slow syndrome during the blank period were selected.In addition,randomly selected patients admitted to the same time to receive atrial fibrillation catheter ablation and there is recurrence during the blank period but no long intermittent patients with 60 cases as B group,and the other randomly selected to receive atrial fibrillation catheter ablation and no recurrence of blank 60 cases of patients with atrial fibrillation ablation as group C.Statistics of these patients gender,age,underlying diseases,patients were followed up to observe the treatment,prognosis,compared between the three groups before and after ablation of HRV differences.Results :(1)From January 2002 to June 2016,there were 1619 cases of atrial fibrillation catheter ablation in the First Affiliated Hospital of Dalian Medical University,and 30 cases(incidence rate 1.9%)occurred fast-slow syndrome in the blank period.(2)There was no significant difference in age,sex and underlying disease between the three groups(P> 0.05).(3)In the three groups,the parameters of HRV were lower than those before operation,but there was no significant difference(P> 0.05)in group A(P> 0.05).In group B,only SDNN,SDANN(P <0.05).In the C group,HRV was statistically significant(P <0.05)(4)There was significant difference in SDNN and SDANN between group A and group B(P <0.05).There was significant difference between group A and group C after catheter ablation(P <0.05)(5)30 patients were selected for this period,according to the wishes of patients,catheter ablation,pacemaker implantation,observation.The mean follow-up was36.9 ± 23.9 months,and 12 patients(40%)in group A underwent re-catheter ablation(8 cases were ablation during blank period and 4 cases were blank after blank).Ten patients had no atrial fibrillation or long intermittent,2 patients were still postoperative atrial fibrillation,but no long intermittent;group A 3 patients(10%)blank implanted permanent pacemaker.15 patients(50%)and other patients(follow-up period of 12 patients without atrial fibrillation and other atrial arrhythmias recurrence,3 patients,although there are still recurrence of atrial fibrillation,but no RR long intermittent).Conclusion:1.paroxysmal atrial fibrillation catheter ablation,a small number of patients will appear fast-slow syndrome during the blank period(1.9%),may be related to nerve imbalance and vagus nerve active.2.For such patients,most of the prognosis is benign and reversibility.