Correlation Analysis Between Preoperative Left Atrium Size And Short-term Efficacy After Radiofrequency Ablation

Objective:Through the line of radiofrequency ablation in patients with valvular disease combined AF patients after the recent curative effect of follow-up,patients with preoperative clinical data collected and the correlation of short-term curative effect on the postoperative,and simple mitral valve lesions AF patients with early postoperative left atrial reverse remodeling and the relevance,different types of short-term curative effect on the patients with postoperative mitral valve lesions after surgery in the near future curative effect difference,line to patients with radiofrequency ablation for the future clinical decision to provide more theoretical support,as well as different types of lines after radiofrequency ablation in patients with drug maintenance provide theoretical basis for the choice of treatment.Methods:(1)Selected from January 2017 to April 2018 in our hospital cardiac surgery line valve surgery over the same period radiofrequency ablation,80 cases of patients,all patients were accord with radiofrequency ablation indications,postoperative no contraindications to oral anticoagulant drugs.(2)Collect patients with preoperative general clinical data,including:age,gender,LAD,LVEDD,LVEF,AF category,complications,heart function level(NYHA),history of anticoagulant/antiplatelet,monitoring.Follow-up of patients with sinus rhythm conversion for 3 months,6months,12months after surgery,and collect the number of LAD in the third month.Through the follow-up of patients with sinus rhythm conversion at 3 months,6 months and 12 months after radio frequency ablation,the preoperative general clinical data of the patients were compared,and the correlation analysis of postoperative recurrence AF of the patients was conducted through statistical analysis.(3)Patients with simple mitral valve disease combined with AF were selected to analyze the correlation between the degree of left atrial reverse remodeling 3 months after surgery and sinus rhythm conversion 12 months after surgery.And to compare the sinus rhythm conversion of patients with different types of mitral valve lesions at 12 months after surgeryResults:All the patients had no postoperative ?° atrioventricular block,death and other serious complications.Meanwhile,30 patients underwent DVR surgery.Ten patients were treated with DVR+TVP.MVR+TVP was performed in 10 patients,5 of whom were complicated with left atrial thrombosis,and left atrial thrombectomy was performed in the same period.23 patients were treated with MVR alone.Seven patients were treated with AYR alone.Preoperative data of patients such as LVEDD,LVEF,heart function level(NYHA),hypertension,diabetes,smoking,AF category,BMI,were compared with the postoperative sinus rhythm conversion,and the difference was not statistically significant(P>0.05).There was a strong correlation between preoperative left atrial size and sinus rhythm conversion at 6 months and 12 months after surgery(? 0.554?0.471),and the difference was statistically significant(P<0.01).The difference of preoperative sinus rhythm conversion rate of patients at 3 months and 12 months after sugery between LAD>60mm and LAD<60mm was statistically significant(P<0.01),besides,the preoperative sinus rhythm conversion rate of patients with LAD<60mm was significantly higher than patients with LAD>60mm.In patients with simple mitral valve disease complicated with AF,early postoperative left atrial inverse remodeling was the factor affecting the recurrence of AF 12 months after surgery,and there was a positive correlation between the two(p=0.495),and the difference was statistically significant(P<0.01).The rate of sinus rhythm conversion in the mitral stenosis group was significantly higher than that in the mitral insufficiency group 12 months after surgery,and the difference was statistically significant(P<0.05).Conclusion:In patients with valvular disease complicated with AF,the larger the LAD before surgery,the worse the short-term efficacy after radiofrequency ablation.For patients with LAD<60 mm before surgery,the short-term efficacy after radiofrequency ablation was significantly better than that of patients with LAD?60 mm.In patients with simple mitral valve disease combined with AF,the greater the degree of early postoperative left atrial reverse remodeling,the better the short-term postoperative efficacy.In addition,the efficacy of patients with mitral stenosis is better than that of patients with mitral insufficiency.