The impact of intraoperative ablation termination on the prognosis of"Stepwise"ab-lation strategy for long-standing persistent atrial fibrillation
10.20039/j.cnki.1007-3949.2024.10.005
- VernacularTitle:术中消融终止对长程持续性房颤"Stepwise"消融策略预后的影响
- Author:
Tong LIU
1
;
Yang YANG
;
Deyong LONG
Author Information
1. 首都医科大学附属北京安贞医院心律失常中心,北京市 100000
- Keywords:
long-standing persistent atrial fibrillation;
ablation strategy;
ablation termination;
prognosis
- From:
Chinese Journal of Arteriosclerosis
2024;32(10):857-864
- CountryChina
- Language:Chinese
-
Abstract:
Aim To explore the impact of ablation termination on the maintenance of sinus rhythm in long-stand-ing persistent atrial fibrillation(LSPAF)by"Stepwise"ablation strategy.Methods This study involved 260 LSPAF patients who underwent"Stepwise"ablation strategy and clinical characteristics were collected.According to the ablation procedure,the patients were divided into ablation termination group and cardioversion group.The prognostic value of con-version to atrial flutter(AFL)and ablation termination was analyzed using subgroup analysis,followed up for 1 year to ex-plore their impact on prognosis.Results Overall,103(39.6％)cases of LSPAF were terminated by ablation.Compared to the cardioversion group,the courses of atrial fibrillation and left atrial diameter were lower in the ablation ter-mination group(all P＜0.05).At 1 year of follow-up,45(17.3％)patients had experienced recurrence,with no statis-tical difference in the proportion of recurrence between the two groups(all P＞0.05).Compared to preoperative,left atri-al diameter was significantly lower after 1 year regardless of recurrence.In subgroup analysis,conversion to AFL and ab-lation termination was associated with the maintenance of long-term sinus rhythm(all P＜0.05).On multivariable Cox re-gression,the courses of atrial fibrillation,body mass index,left atrial diameter and fasting blood glucose were independent risk factors for recurrence.Conclusions 39.6％of LSPAF recovered sinus rhythm during the"Stepwise"ablation process,but there was no correlation with long-term sinus rhythm maintenance.Termination of ablation after conversion to AFL during ablation has a predictive effect on the maintenance of long-term sinus rhythm.
