Risk Factors Of Atrial Fibrillation After Linear Tricuspid Isthmus Ablation In Typical Atrial Flutter Patients

Objective To analyze the risk factors of atrial fibrillation in patients with typical atrial flutter after linear tricuspid isthmus ablation.Methods Sixty-eight patients with typical atrial flutter and electrophysiological examination confirmed as tricuspid annulus isthmus dependent atrial flutter and successfully performed tricuspid isthmus linear ablation(CTIA)from February 2015 to February 2018 were selected.The average follow-up period was 6-34 months.The patients were divided into two groups according to whether atrial fibrillation occurred or not.Among them,23 were in atrial fibrillation group and 45 were in non-atrial fibrillation group.The differences of age,basic diseases,P wave width and dispersion,left atrial diameter(LAD),left ventricular end-diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF)and oral medication were compared between the two groups.Results Univariate analysis of influencing atrial fibrillation after linear tricuspid isthmus ablation in typical atrial flutter patients showed that P wave width,P wave dispersion,left atrial diameter(LAD),end-diastolic diameter of left ventricle(LVEDD),left ventricular ejection fraction(LVEF)in two groups.There was significant difference in ejection fraction(LVEF)between the two groups(P < 0.05).There was no significant difference in gender,age,underlying diseases and oral drugs between the two groups(P > 0.05).Multivariate regression analysis showed that five variables(P-wave width,P-wave dispersion,LAD,LVEDD,LVEF)with statistical significance in univariate analysis were selected as independent variables,and whether atrial fibrillation occurred after operation was selected as dependent variable.Stepwise regression was used to screen variables.Multivariate logistic regression analysis showed that LAD,P wave width and P wave dispersion were independent risk factors for atrial fibrillation in patients with typical atrial flutter after linear tricuspid isthmus ablation(P < 0.05).Conclusion Line for typical flutter proposed TLA surgery patients,according to the preoperative LAD,P wave dispersion,P wave width to make a full predict the risk of postoperative atrial fibrillation,especially for the significant increase in left atrial diameter,P wave width widened significantly(> 120 ms),P wave dispersion ratio increased obviously(> 40 ms)postoperative high-risk patients with atrial fibrillation,should communicate with their families,in determining the operation strategy when considering joint tricuspid spondylolysis electrical isolation of pulmonary vein linear ablation and ring operation strategy,eventually reduce the incidence of postoperative atrial fibrillation TLA typical room on patients.