Effect Of Left Ventricular Diastolic Function On Recurrence After Catheter Ablation Of Paroxysmal Atrial Fibrillation Guided By New And Old Guidelines

Background:Catheter ablation(CA)has become the standard treatment strategy for most atrial fibrillation(AF)to maintain sinus rhythm.The main procedure is pulmonary vein isolation.However,how to effectively predict postoperative recurrence by distinguishing the clinical features of patients before surgery is a difficult problem to be solved.Previous studies have confirmed the predictive value of left ventricular diastolic function for postoperative recurrence of atrial fibrillation,but the criteria for determining left ventricular diastolic function have been controversial.The article is aim to evaluate the effect of left ventricular diastolic function under the guidance of new and old guidelines on late recurrence after transcatheter radiofrequency ablation(RFCA)in patients with paroxysmal atrial fibrillationObjective:The purpose of this study is to evaluate the efficacy of radiofrequency catheter ablation in patients with paroxysmal atrial fibrillation who were treated in our hospital,and to evaluate the effect of left ventricular diastolic function evaluation under the guidance of new and old guidelines on late recurrence after RFCA in patients with paroxysmal atrial fibrillation.Methods:Retrospective data on 211 consecutive patients(109males,102females)with paroxysmal atrial fibrillation who underwent RFCA in the Department of cardiology from 2016 to 2017 were included.Patient baseline data and echocardiographic findings were collected and left ventricular diastolic function was assessed using the 2009 ASE/EAE guidelines and the 2016 ASE/EACVI guidelines.The blank period was 3 months after operation.The patients were followed up at least 12 months after surgery.According to the follow-up results,the patients were divided into the non-recurrent group and the recurrent group to investigate the effect of left ventricular diastolic function evaluation under the guidance of the old and new guidelines on the late recurrence after RFC A in patients with paroxysmal atrial fibrillation.Results:After a follow-up of an average of 27 months,55 patients(26%)had recurrent AF whereas 156patients(74%)maintained sinus rhythm.Kaplan-Meier survival analysis showed that regardless of which version of the guideline evaluated left ventricular diastolic function,left ventricular diastolic dysfunction increased the risk of late recurrence after paroxysmal atrial fibrillation.It can be found that the 2016 version of left ventricular diastolic function has a better correlation with the 2009 left ventricular diastolic function and late recurrence after paroxysmal atrial fibrillation(?2=16.815,P=0.000 vs.?2=8.357,P=0.004).In the Cox proportional hazard model analysis,left ventricular diastolic dysfunction assessed in the 2016 guideline(HR 2.29,95%CI 1.08-4.83,P=0.030)and E-peak deceleration time(HR 1.00,95%CI 1.00-1.01,P=0.047)were found to be independent risk factors for recurrence after transcatheter ablation in patients with paroxysmal atrial fibrillation,and the 2009 guideline evaluated left ventricular diastolic function and any single reference included in the 2016 edition of the guideline was not statistically significant.Conclusion:The postoperative late recurrence rate was 26.1%in patients with paroxysmal atrial fibrillation undergoing catheter ablation in our hospital;there is a better correlation between left ventricular diastolic function assessed by the 2016 ASE/EACVI guidelines and postoperative recurrence of paroxysmal atrial fibrillation compared to left ventricular diastolic function assessed in the 2009 ASE/EAE guidelines and any single indicator included in the 2016 guidelines.