Clinical Study On Catheter Ablation Of Persistent Atrial Fibrillation Under The Guidance Of Visitag

Background:Atrial fibrillation is a common arrhythmic disease in clinic.According to statistics.atrial fibrillation leads to a 1.5-fold increase in all-cause mortality in males and a 2-fold increase in females.At present,there are two main methods for the treatment of atrial fibrillation,including drug therapy and non-drug therapy.Drug therapy includes control of ventricular rate,anticoagulation therapy,control of rhythm,prevention of recurrence.The effect of drugs in the treatment of atrial fibrillation is poor,it is easy to be repeated,and it has many side effects when taken for a long time.In a study of long-term use of antiarrhythmic drugs(amiodarone),it was found that the incidence of liver function and nervous system dysfunction was4%-25% and 20%-40%.In recent years,catheter ablation has gradually become a hot topic in the treatment of atrial fibrillation.Compared with antiarrhythmic drugs,radiofrequency catheter ablation can better control the ventricular rate and improve the quality of life of patients with atrial fibrillation.Electrical isolation of circumferential pulmonary vein is the basis of radiofrequency ablation of atrial fibrillation.The formation of continuous,complete and lasting transmural injury is the key to radiofrequency ablation.It has always been a difficult problem to judge the adhesion between catheter and tissue in radiofrequency ablation of atrial fibrillation.Visiag is a kind of software in CARTO3 system to record and analyze the ablation effect,which can provide real-time stability between tissue and catheter attachment,feedback ablation parameters such as ablation power,time and pressure to the operator,and color-mark the ablation point,so that the operator hasan objective basis for judging the stability of catheter attachment and improves the success rate of operation.Objective: To evaluate the clinical effect of radiofrequency ablation of persistent atrial fibrillation under the guidance of Visitag system Methods: A retrospective study was conducted on 110 patients with persistent atrial fibrillation who underwent catheter ablation in the Department of Cardiology,Yijishan Hospital of Southern Anhui Medical College from January2017 to December 2018.According to the operation time,48 patients with persistent atrial fibrillation were treated with ablation of persistent atrial fibrillation under the guidance of non-Visi Tag.62 cases were selected to use Visitag software to guide ablation as the study group.The selected patients with atrial fibrillation were completed by skilled operators in our department,and the circumferential pulmonary vein ablation to pulmonary vein electrical isolation was adopted during the operation.The results of ablation time(min),X-ray fluoroscopy time(min),single circle isolation rate,number of points outside the ablation diameter and operative complications were compared between the two groups after operation.The patients were followed up for one year,and the recurrence rate of one year after ablation was compared between the two groups.Results: After catheter ablation,it was found that the ablation discharge time of the study group was similar to that of the control group(43.84 ±3.33 vs 44.71±3.26,p = 0.092),and there was no statistical difference.The isolation rate of ablation lap has been improved(94% vs 77%).There was no significant difference in X-ray fluoroscopy time(3.34 ±0.51vs3.23 ±0.47).The total number of supplementary points outside the ablation line(23vs149)was reduced,and the incidence of operation-related complications(pericardial tamponade)was relatively reduced.After 1-year follow-up,the 1-year success rate of atrial fibrillation ablation in the study group was higher than that in the control group(77% vs 58%).Conclusion: Continuous transmural injury is very important for the success of radiofrequency ablation of atrial fibrillation.In radiofrequency ablation of atrial fibrillation,it is necessary to ensure the stable attachment of catheter and myocardial tissue,reduce ablation repair points as much as possible,form continuous,complete and lasting transmural injury,and achieve complete electrical isolation of pulmonary vein.For patients with persistent atrial fibrillation,using Visi Tag to guide catheter ablation of atrial fibrillation can improve the rate of single-loop isolation and reduce the number of filling points.Improve the success rate of operation.Ablation of persistent atrial fibrillation under the guidance of Visi Tag is a safe and effective ablation strategy.