| Objective: Atrial fibrillation(AF)is a very common arrhythmia in modern clinic.In addition to using anticoagulants to prevent stroke in high-risk patients,heart rate control or antiarrhythmic drugs to maintain sinus rhythm,catheter ablation has also become a method for the treatment of AF,and surgical methods have been developed for the treatment of atrial fibrillation.Radiofrequency ablation and cryoballoon ablation are both effective methods of catheter ablation for pulmonary vein isolation.At present,there are many studies comparing the two ablation methods,most of which show non-inferiority in safety and efficacy.However,there are still few data on their impact on patients' quality of life and cognition.Catheter ablation is an independent risk factor for ischemic stroke in patient with AF,so it is important to evaluate the quality of life and cognition of patients after catheter ablation.In this study we aim to compare the effects of two ablation methods on quality of life and cognition in patients with AF.Methods: Patients with AF who were admitted to the Department of Cardiology,theSecond Affiliated Hospital of Dalian Medical University from January 2018 to January2019 and were willing to accept catheter ablation,were continuously errolled in the study.Ablation method,radiofrequency ablation or cryoablation was chosen according pulmonary anatomy and patient's choice.Both cryoablation and radiofrequency ablation were performed by the same ablation expert.1day before ablation,and 1 day,3 months,6 months,1 year after ablation,the assessments of the patients' quality of life and cognitive function in two groups were performed,including SF-12,EQ-5D,MMSE and ADCS-ADL respectively.The ablation complications of the patients were collected.The recurrence of atrial tachycardias in the patients was collected also.The ablation procedure time and X-ray exposure were collected.The general clinical data,including gender,age,atrial fibrillation type,length of atrial fibrillation history,hypertension,diabetes,body weight index,left atrial diameter,left ventricular ejection fraction,left ventricular of end diastolic diameter CHA2DS2-VASc score and HAS-BLED score were collected retrospectively.The SPSS 23.0 statistical software was used for data analysis.When the measuring data were normally distributed,we discribed them as mean ± standard deviation((?) ± s),when they were non-normal distribution wepresented them by the median(quartile spacing).Counting data were expressed as frequency or percentage.The mean of two samples of measurement data was compared by t test,and the repeated measurement data were compared by repeated measurement analysis of variance.We compared the counting data by chi-square test.P<0.05 indicated that the difference was statistically significant.Results: A total of 88 cases were collected,55 cases in the cryoablation group and 33 cases in the radiofrequency ablation group,including 54 males and 34 females,63 cases of paroxasmal AF and 25 cases of persistent AF,with an average age of 62.3±7.2 years old.There was no significant difference in the general clinical data between radiofrequency ablation and cryoablation group(P>0.05).In both radiofrequency ablation and cryoablation group,scores of SF-12,EQ-5D,EQ-VAS,MMSE and ADCS-ADL were statistically significant increased at 1 day,3 months,6 months and 1year after ablation than 1 day before ablation,(P<0.05).However,there was nosignificant difference between the radiofrequency ablation group and the cryoablation group 1 day before ablation,one day,3 months,6 months and 12 months after ablation(P>0.05).After 12 months follow-up,in the radiofrequency ablation group,7 cases had recurrence within 3 months after ablation(21.21%),and 5 case had recurrence after 3months ablation(15.15%);in the cryoablation group,4 cases had recurrence within 3months after ablation(7.27%),and 6 case had recurrence after 3 months ablation(10.91%).About complication,there were 1 case(3.03%)in the radiofrequency ablation group and 2 cases(3.63%)in the cryoablation group.There was no significant difference in recurrence rate and complications between radiofrequency group and cryoablation group(P>0.05).Compared with the radiofrequency group,the ablation procedure time in the cryoablation group was shorter than radiofrequency group(96.04±22.61 min vs 134.33±42.51 min,P<0.05).In the comparison of X-ray exposure dosage,the cryoablation group was higher than radiofrequency group(145.78±112.92 mGy vs 67.79±18.41 mGy,P<0.05).Conclusion: Both radiofrequency ablation and cryoablation can improve the quality of life and cognitive function of patients with atrial fibrillation.There was no significant difference in the improvement of the quality of life and cognitive function in patients with atrial fibrillation between radiofrequency ablation and cryoablation group. |
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