The Predictive Value Of Combination Of Multiple Indices For Postoperative Outcomes Of Radiofrequency Ablation For Nonvalvular Atrial Fibrillation

Objective: To investigate the independent predictors of radiofrequency ablation for atrial fibrillation and to establish a multi-index predictive model for AF recurrence after Radiofrequency ablation.Methods: Retrospective analysis of the clinical data of 136 non valvular atrial fibrillation patients who underwent radiofrequency ablation(RFCA)of atrial fibrillation at our hospital from January 1,2014 to August 1,2022,who met the inclusion criteria.Based on the follow-up results after radiofrequency surgery,they were divided into a postoperative adverse group of 39 cases and a postoperative good group of 97 cases.Using single factor analysis and multiple factors Logistic regression analysis to explore the independent prognostic factors of recurrence of atrial fibrillation.Draw the independent prognostic factor and joint application,the ROC curve to determine the critical value,the AUC,the sensitivity,specific degrees,observe the independent predictors and combined use of clinical expected effect.The weighted prediction score(unw Score)model was constructed,and by comparing with APPLE grading and DRFLASH score AUC,predictive value of evaluation indexes more joint model.Results:1.Single factor analysis showed that there were significant differences in f wave amplitude,left atrial diameter(LAD),red blood cell distribution width(RDW),non-paroxysmal atrial fibrillation(non-PAF)and number of blank episodes between the two groups,there was statistical significance(P<0.05).The critical values of f-wave amplitude,LAD and RDW were calculated by ROC curve.The measured data were transformed into dichotomous variables according to the critical values of each index,RDW>13.15% 、LAD>39.5mm、f wave amplitude <0.1195 mv were a significant difference between the two groups.(P<0.05)2.Binary Logistic regression analysis results showed that f wave amplitude <0.1195mv(OR=9.398,95%CI:3.287~26.866,P<0.05),LAD>39.5mm(OR=4.331,95%CI:1.433~13.091,P=0.009),Blank period attack(OR=8.875,95%CI:2.737~28.784,P<0.05)and non-PAF(OR=4.446,95%CI:1.502~13.159,P=0.007)were independent predictors of postoperative adverse after RFCA.3.Comparison of AUC:LAD>39.5 mm,f-wave Amplitude<0.1195 mv,non-PAF,blank period attack combined is more effective than any single index to evaluate the recurrence of AF after ablation,it was more reliable to predict postoperative recurrence(P<0.05).Four.unw Score model(AUC = 0.886,95% CI 0.822 ~ 0.951)was superior to Apple score(AUC =0.621,95%CI 0.517 ~ 0.726,P<0.05)and DRFLASH score(AUC = 0.541,95% CI 0.435 ~0.647,P<0.05).Conclusion: LAD,f-wave amplitude,non-PAF,blank period,RDW were significantly associated with the prognosis of AF Radiofrequency ablation 0.1195 mv,Blank period and non-PAF were independent predictors of adverse outcomes after RFCA.Multi-index joint assessment is more effective than any single index in assessing recurrence after ablation of AF,and the unwscore model is superior to some published and tested scoring systems in predicting postoperative recurrence.In conclusion,clinicians can use the combined index model to predict the probability of postoperative recurrence and identify high-risk patients,thus selecting better surgical procedures and antiarrhythmic agent to reduce postoperative recurrence,improve the prognosis of patients.