Analysis Of Related Factors Of Arrhythmia Recurrence After Bipolar Radiofrequency Ablation Under Atrial Fibrillation Surgery

Objective:To investigate the risk factors of recurrence of arrhythmia in patients Who underwent open-heart thoracic surgery and Atricure bipolar radiofrequency Ablation(BRFA)under direct vision,and it maybe provide guidance for clinical work.Methods:Retrospective analysis of clinical data of 62 patients with cardiac surgery and persistent atrial fibrillation treated in our hospital from July 28,2016 to February26,2019.These patients underwent related cardiac surgery and concurrent bipolar radiofrequency ablation(BRFA).All subjects were followed up after the operation,and the follow-up time was ≥6 months.Collect relevant clinical indicators of patients,Analyze patient follow-up results and effectiveness.And divide patients into two groupes based on the ECG results from the last review,Compare relevant clinical data of two groups of patients,Corresponding statistical methods were used to study the factors related to the recurrence of arrhythmia after surgery.Results:After a follow-up of 13.6 ± 7.6 months,49(79%)patients were converted to sinus rhythm,13(21%)patients were non-sinus rhythm,of which 10(16%)were AF and 2(3%)were atrial flutter,and 1 case was supraventricular tachycardia(2%).There were no deaths among the 62 patients in this group.The extracorporeal circulation time during the operation was 122.87 ± 27.21 min,the aortic occlusion time was 87.26 ± 25.01 min,the postoperative ventilator assisted ventilation time was0.87 ± 0.78 d,and the ICU stay time was 2.20 ± 1.19 d.In the perioperative period,there were 3 cases of poor surgical incision healing,2 cases of third-degree atrioventricular block,2 cases of pulmonary infection,and 1 case of phrenic nerve injury and diaphragmatic elevation.Patients with complications were given antiinfection,dressing change,and implantation.The permanent pacemaker was discharged after being treated accordingly.There was no statistical difference between the sinus rhythm group and the non-sinus rhythm group in gender,age,hypertension,diabetes,coronary heart disease,cerebral infarction,rheumatic heart disease,cardiac function classification,LVEDD,LVESD,LVEF,etc.(P> 0.05).The duration of atrial fibrillation in the non-sinus rhythm group(P = 0.011)and the inner diameter of the left atrium(P = 0.021)were higher than those in the sinus rhythm group,with statistical differences.Putting the duration of atrial fibrillation and the left atrial diameter into a binary logistic regression model showed that the duration of atrial fibrillation(OR = 0.072,95% CI = 0.008-0.670,P = 0.021)and the left atrial diameter(OR = 1.143,95% CI = 1.021-1.280,P = 0.020)is an independent predictor of non-sinus rhythm.Conclusion:Concurrent bipolar radiofrequency ablation(BRFA)is an effective method for radical atrial fibrillation,and it is worth promoting.Atrial fibrillation duration and left atrial diameter were independent predictors of recurrence of tachyarrhythmias after radiofrequency ablation.Surgical radiofrequency ablation has not reduced the recurrence rate of tachyarrhythmia after increasing the ablation path,which may be related to the ablative non-transmural injury caused by the individualized difference in the thickness of myocardial tissue and the no-working area of the radiofrequency ablation forceps tip.