Status quo and influencing factors of atrial fibrillation recurrence in elderly patients after radiofrequency catheter ablation
Objective To investigate the status quo and influencing factors of atrial fibrillation(AF)recurrence in the elderly patients after radiofrequency catheter ablation(RFCA).Methods A sample of 794 AF patients who received RFCA treatment in Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine from January 2019 to December 2019 were selected in this study.The patients were followed up with 24-hour dynamic electrocardiogram for 1 year,and they were divided into recurrence group and control group according to whether there was recurrence.The risk factors of postoperative recurrence were analyzed.A logistic regression model was established,and its predictive value was evaluated.SPSS statistics 23.0 was used for statistical analysis.Data comparison between two groups was performed using t test or χ2 test depending on data type.Multivariate logistic regression analysis was performed to investigate the influencing factors of AF recurrence in elderly patients after RFCA.Results During 1-year follow-up,8(1.01%)of the 794 patients were lost to follow-up,and 104(15.25%)of the 786 patients who completed the follow-up had recurrence.Multivariate logistic regression analysis showed that age(OR=1.113,95%CI 1.041-1.190),diabetes mellitus(OR=1.697,95%CI 1.018-2.831),left atrial diameter(LAD;OR=1.135,95%CI 1.025-1.257),low-density lipoprotein cholesterol(LDL-C;OR=1.229,95%CI 1.044-1.446)and high-sensitivity C reactive protein(hs-CRP;OR=1.096,95%CI 1.004-1.197)were independent risk factors of AF recurrence in elderly patients after RFCA(P<0.05).Receiver operating characteristic(ROC)curve analysis showed that the area under the curve in the logistic regression model for predicting the AF recurrence risk in the patients after RFCA was 0.939(95%CI 0.885-0.973;P<0.00),and Hosmer-Lemeshow test indicated a good consistency between the predictive value and the observed value(χ2=1.279;P=0.461).Conclusion The AF recurrence rate after RFCA is high in elderly patients,and age,diabetes mellitus,LAD,LDL-C and hs-CRP are independent risk factors of postoperative recurrence.A logistic regression model based on the above factors has a good reference value in predicting recurrence.
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