Effect of radiofrequency ablation on different left ventricular ejection fraction heart failure with persistent atrial fibrillation
Objective To investigate the efficacy of radiofrequency ablation on different left ventricular ejection fraction(LVEF)heart failure(HF)with persistent atrial fibrillation(AF).Methods Sixty patients with HF with persistent AF who underwent radiofrequency ablation in the cardiovascular Department of Jiaozuo People's Hospital from October 2018 to October 2022 were selected as the study objects.According to LVEF,they were divided into group R(LVEF＜40％,n=32)and group M(40％≤ LVEF＜50％,n=28).The cardiac function grades according to New York College of Cardiology(NYHA),cardiac function indexes[LVEF,left atrial anterior and posterior diameter(LAD),left ventricular end diastolic diameter(LVEDd),6 minute walking distance(6MWD),N-terminal brain natriuretic peptide precursor(NT-proBNP)],heart valve changes(mitral regurgitation,tricuspid regurgitation),intraoperative events(electrical cardioversion,HF episodes,other atrial arrhythmias,cerebrovascular events),re-hospitalization,and recurrence were compared between the two groups.Results After treatment,NYHA grades in both groups were lower than those before treatment,with significant differences(P＜0.05),but there was no significant difference between the two groups(P＞0.05).After treatment,the levels of LVEF and 6MWD were significantly higher than those before treatment,the levels of LAD,LVEDd and NT-proBNP were significantly lower than those before treatment,with significant differences(P＜0.05).There was no significant difference between the two groups before and after treatment(P＞0.05).After 6 months of treatment,mitral valve regurgitation and tricuspid valve regurgitation were significantly reduced in the two groups,the differences were significant(P＜0.05),but there was no significant difference between the two groups(P＞0.05).The incidence of HF acute attack and atrial arrhythmia in group R was significantly higher than that in group M,and the differences were significant(P＜0.05).There was no significant difference in the incidence of electrocardioversion and cerebrovascular events,the rate of re-hospitalization and recurrence at 6 months and 1 year after treatment between the two groups(P＞0.05).Conclusions Radiofrequency ablation has a significant effect on different LVEF HF with persistent AF,which helps to improve cardiac structure and function,symptoms and prognosis.However,patients with LVEF＜40％have a relatively high risk of acute HF attack and atrial arrhythmia during operation.
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