A retrospective cohort study on the clinical effect of radiofrequency ablation for atrial fibrillation without radiation in surgical operating room

FANG Jia-yuan; CHENG Hui; YU Lu; JIANG Ru-hong; LIU Qiang; LIN Jian-wei; SUN Ya-xun; ZHANG Pei; JIANG Chen-yang

doi:10.19538/j.nk2024030107

Abstract：Objective To evaluate the safety and efficacy of radiofrequency ablation for atrial fibrillation in the surgical operating room without DSA(digital subtraction angiography).Methods Patients who underwent radiofrequency ablation for atrial fibrillation in the surgical operating room of Sir Run Run Shaw Hospital,Zhejiang University School of Medicine from January 2021 to June 2022 were enrolled,and patients who underwent ablation for atrial fibrillation during the same period were selected as the Cath Lab group for control in a 1∶1 pair,using patient's age,gender,and BMI as the main matching characteristics.Finally,149 patients in the operating room group and 152 patients in the Cath Lab group were in cohort to observe clinical endpoints such as complications of AF ablation procedures and 1-year AF recurrence.Results There was no significant difference in the incidence of main perioperative complications between the two groups,including pericardial effusion 2.01％(3/149)vs.1.97％(3/152)(P=0.980);esophageal injury 0％(0/149)vs.0.66％(1/152)(P=0.321).There was no difference in the 1-year success rate between the two groups.Survival analysis showed 95.59％(130/136)vs.91.72％(122/133)(P=0.172).Multivariate Cox regression showed that operating room was not an independent risk factor for postoperative recurrence(HR=0.32,P=0.054).The operating room group had the advantages in postoperative fever and the length of hospital stay:postoperative fever 2.01％(3/149)vs.8.55％(13/152)(P=0.011);the mean hospital stay(3.3±1.2)days vs.(4.3±1.8)days(P=0.001),and the procedure time had no difference(145.9±41.6)min vs.(154.6±45.1)min(P=0.139).Conclusion Catheter ablation for atrial fibrillation in a DSA-free surgical operating room is comparable in effective-ness,safety,and procedure time when compared with a conventional Cath Lab.