Clinical Observation On Therapeutic Effects Of Radiofrequency Catheter Ablation To Treat Atrial Fibrillation-induced Cardiomyopathy

Objective:Heart failure(HF)caused by atrial fibrillation(AF)is called AF-induced cardiom-yopathy,which is characterized by significant improvement in clinical symptoms and cardiac function,and the structure of the heart can be reversed if there are some radical treatments for AF.The research mainly observes the clinical efficacy of radiofrequency catheter ablation(RFCA)for patients with AF-induced cardiomyopathy.Methods:We retrospectively collected 21 atrial fibrillation Patients with heart failure symptoms or cardiac enlargement(13 males,8 females),who were admitted to the second ward of department of cardiology and underwent Catheter radiofrequency ablation at ShanXi provincial people,s hospital from 2010 to 2017.Age(55.4 ±13.8)years old.Before operation,echocardiography suggested that the left atrium anteroposterior diameter(LAD)was(42.1 ± 6.4)mm,the right atrium anteroposterior diameter(RAD)was(43.1± 9.7)mm,the left ventricular end diastolic diameter(LVEDD)was(51.5 ± 6.6)mm,the left ventricular ejection fraction(LVEF)was(56.3 ± 12.9)%.6patients had a reduced LVEF,and the lowest was 32.0%.The NYHA heart function was2.0(1.0,4.0).These patients underwent Catheter radiofrequency ablation,then follow-up observation.Results:The median follow-up time was 24.0(12.0,60.0)months.15 patients(71.4%)maintained sinus rhythm,Holter showed no atrial fibrillation,6 patients experienced recurrence,4 showed rapid AF(HR?150 bpm),2 was atrial flutter.Only one atrial fibrillation was converted to sinus rhythm(SR)after direct current cardioversion,and the rest of the patients failed to SR were guided to control the ventricular rate.1 AF case experienced recurrence again after the second ablation.The recurrence cases of early,mid and late were 2,2,and 2.Echocardiography showed that,after the procedure,patients? LAD and RAD were significantly reduced to(36.8 ± 5.2)mm and(35.4 ± 8.0)mm,and LVEF was increased to(64.5 ± 7.4)%,(all P?0.05),all patients? LVEF?50.0%.Although LVEDD [(48.8 ± 3.6)mm] was also smaller than before,there was no significant difference(P=0.198).The NYHA heart function was 1.0(1.0,1.0),lower at least one level than before(P=0.002).In the recurrent group and the successful group,LAD were(41.5 ± 4.8)mm and(34.9 ± 4.1)mm(P=0.004);RAD were(43.2 ± 8.5)mm and(32.3 ± 5.5)mm(P=0.002),respectively,after surgery.Complications: 1 case had hematoma at the puncture site,then relieved after symptomatic treatment,there were no severe surgery complications in other patients.Conclusion:The successful rate of the radiofrequency catheter ablation for patients with AFinduced cardiomyopathy is high.After operation,patients maintaining sinus rhythm whose cardiac structure and function will significantly improve.The complications of operation are gradually reduced.RFCA offers a new hope for the treatment of patients with AF-induced cardiomyopathy.