Effects of high-power short-duration radiofrequency ablation under different ablation indices guidance on echocardiography,complications and postoperative recurrence in patients with atrial fibrillation
TANG Liang
ZHANG Jin-peng
CHEN Yue-xiang
WU Miao-min
Abstract：Objective To investigate the effects of high-power short-duration(HPSD)radiofrequency ablation guided by different ablation indices(AI)on echocardiography,complications and postoperative recurrence in patients with atrial fibrillation(AF).Methods A total of 80 patients with atrial fibrillation(AF)who underwent radiofrequency catheter ablation at Heyuan People's Hospital from November 2019 to October 2023 were selected and randomly divided into the low AI group and the high AI group using a random number table method,40 patients in each group.Both groups underwent HPSD ablation under AI guidance.The target AI for ablation in the low AI group was 350-400 for the anterior wall and 320-350 for the posterior wall,while the target AI for ablation in the high AI group was 450-500 for the anterior wall and 350-400 for the posterior wall.The perioperative indicators,ablation effects[pulmonary vein isolation(PVI)status,PVI single-loop isolation rate],intraoperative popping(POP)sound incidence,pre-and post-operative echocardiographic indicators[left ventricular ejection fraction(LVEF),left ventricular end-systolic diameter(LVESD),left ventricular end-diastolic diameter(LVEDD),E/A ratio],recurrence-related markers[soluble growth-stimulating expression gene 2(sST2),uric acid(UA),fibroblast growth factor-23(FGF-23)],perioperative severe complication rate and the recent recurrence were compared between the two groups.Results The ablation time,PVI time,left atrial operation time and operation time per point in the high AI group were shorter than those in the low AI group[(13.42±1.28)min vs.(15.67±1.76)min,(26.58±3.19)min vs.(29.24±2.42)min,(4.37±1.25)min vs.(5.16±1.38)min,(121.67±20.35)min vs.(132.48±22.19)min,P＜0.05].The single-lap isolation rate of PVI in the high AI group was higher than that in the low AI group(87.50％vs.67.50％,P＜0.05).There was no significant difference in the incidence of POP sound during the operation between the two groups(P＞0.05).The LVEF in the high Al group after the surgery was higher than that in the low AI group[(69.32±2.15)％vs.(68.01±2.27)％,P＜0.05].The LVESD and LVEDD were smaller than those in the low AI group[(25.61±2.29)mm vs.(27.38±2.53)mm,(44.57±2.54)mm vs.(46.22±2.86)mm,P＜0.05].The levels of serum sST2,UA and FGF-23 in the high AI group after surgery were lower than those in the low AI group[(45.86±10.29)pg/ml vs.(53.01±12.30)pg/ml,(286.37±22.05)μmol/L vs.(302.65±24.18)μmol/L,(165.24±22.97)μg/L vs.(183.76±25.42)μg/L,P＜0.05].The incidence of severe complications during the perioperative period and the recurrence rate 3 months after the surgery in the high AI group showed no significant difference compared with the low AI group(P＞0.05).Conclusion HPSD ablation under the guidance of high AI can optimize the surgical process,enhance the isolation effect of PVI,promote the recovery of cardiac function,and inhibit the expression of relapse markers in AF patients,and the short-term effect and safety are comparable to that of low AI.
Keywords：Atrial fibrillationAblationAblation indexHigh powerShort-time rangeEchocardiographyComplicationsRecrudescence
Publication Date：2024-08-10
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 757-762 )