Correlation Between Left Ventricular Hypertrophy And Persistent AF Recurrence After Radiofrequency Ablation

Objective:To explore the effect of left ventricular hypertrophy(LVH)on the success rate of catheter ablation of persistent atrial fibrillation(per AF)and to explore the use of left ventricular mass index(LVMI)alone or in combination with other ultrasound parameters in predicting long-term recurrence after catheter ablation of persistent atrial fibrillation the value of.Methods:In this study,92 perAF patients who underwent atrial fibrillation catheter radiofrequency surgery in the Department of Cardiovascular Medicine of the First Affiliated Hospital of Wannan Medical College from January 2019 to January 2020 were included in the study.Preoperatively collect the patient’s gender,age,disease history,echocardiographic parameters,serological indicators,body mass index and other clinical data.According to the LVH diagnostic criteria:male LVMI>116g/m~2,female LVMI>104g/m~2,all patients Divided into LVH group(n=42)and non-LVH group(n=50);all patients underwent circular pulmonary vein isolation(CPVI),and the left atrial low voltage area(LVA)was mapped at the same time.After 12 months of follow-up,independent samples were used The T test compares the general clinical data between the two groups and analyzes the correlation between LVMI and left atrial diameter(LAD),LVEF and LVA,and compares the difference in the success rate of catheter ablation between the two groups.Univariate and multivariate Logistic regression analysis of factors affecting recurrence after catheter ablation,drawing receiver operating characteristic curve(ROC)and area under the ROC curve(AUC)to judge their value in predicting long-term recurrence after CA.Results:The differences in LAD,LVDD,LVEF,ISVT and hypertension history between the LVH group and the non-LVH group were statistically significant(P<0.05);after 12months of follow-up,the success rate of catheter ablation in the LVH group was lower than that of the non-LVH group(52.4%vs.76.0%,P<0.01);LVMI has a positive correlation with LAD and LVA(r=0.27 and r=0.45 P<0.05),but has a negative correlation with LVEF(r=-0.25 P<0.05)).The results of binary logistic regression analysis showed that LVMI>101.18g/m2 and LAD>44.5mm were independent risk factors for predicting recurrence after catheter ablation in per AF patients;the AUCs of LVMI and LAD for predicting recurrence after CA were 0.771 and 0.762 respectively,which were sensitive The degrees were 0.758 and 0.636,and the specificities were 0.579and 0.814,respectively.The combined assessment model composed of LVMI+LAD predicts the AUC of recurrence after CA is 0.853,the sensitivity is 0.758,and the specificity is 0.831.Conclusion:PerAF patients with LVH often have hypertension and low LVEF,and LVH is closely related to the structural remodeling of the left atrium;the success rate of catheter ablation in per AF patients with LVH is lower;LVMI>101.5 g/m2 and LAD>44.5mm is an independent risk factor for predicting recurrence after catheter ablation in per AF patients.LVMI combined with LAD is more reliable in predicting recurrence after catheter ablation in per AF patients.