loading page

A novel predictive model of recurrence after surgical ablation of valvular atrial fibrillation
  • +9
  • Yali Wang,
  • Xinlong Tang,
  • Adili Ailiya,
  • Can Xu,
  • Xiyu Zhu,
  • Yi Jiang,
  • Yunxing Xue,
  • Fudong Fan,
  • Hailong Cao,
  • Jun Pan,
  • Qing Zhou,
  • Dongjin Wang
Yali Wang
Nanjing University
Author Profile
Xinlong Tang
Nanjing University Medical School Affiliated Nanjing Drum Tower Hospital
Author Profile
Adili Ailiya
Nanjing University Medical School Affiliated Nanjing Drum Tower Hospital
Author Profile
Can Xu
Nanjing Drum Tower Hospital
Author Profile
Xiyu Zhu
Nanjing Drum Tower Hospital
Author Profile
Yi Jiang
Nanjing Medical University
Author Profile
Yunxing Xue
The Affiliated Drum Tower Hospital of Nanjing University Medical School
Author Profile
Fudong Fan
Nanjing University Medical School Affiliated Nanjing Drum Tower Hospital
Author Profile
Hailong Cao
Nanjing University Medical School Affiliated Nanjing Drum Tower Hospital
Author Profile
Jun Pan
Nanjing University Medical School Affiliated Nanjing Drum Tower Hospital
Author Profile
Qing Zhou
Nanjing University Medical School Affiliated Nanjing Drum Tower Hospital
Author Profile
Dongjin Wang
Nanjing University Medical School Affiliated Nanjing Drum Tower Hospital
Author Profile

Abstract

Background: Radiofrequency ablation(RFA) has emerged as a common approach to treatment of atrial fibrillation(AF) coupled with valve surgery. However, risk factors were rarely reported on recurrence after RFA of valvular atrial fibrillation . Methods: Retrospective study of a single-center database was performed in patients underwent valvular surgery combined with radiofrequency ablation. Follow-up was conducted from 3 months to 1 year after procedure. AF recurrence was defined as any episode of atrial arrhythmia lasting more than 30 seconds. Risk factors were analysis using Logistic regression and a predictive model was established. Results: 3-month follow-up was completed in 319 patients, 195 patients (61.1%) had AF recurrence. During the 1-year follow-up, 74 /166 patients(44.6%) had AF recurrence. Compared with sinus rhythm maintenance group, overweight(p=0.022), high BMI(p=0.024), large preoperative LAD(p<0.001), small MI area(p=0.019), large MI diameter(p<0.001) and other liver function parameter like low ALT level(p=0.023), high total bilirubin(p=0.013) and direct bilirubin level(p=0.033) were significantly correlated with AF recurrence after RF. In multivariate analysis, BMI(OR 1.12, 95% CI 1.04-1.21, p=0.003), LAD(OR 1.49, 95% CI 1.09-2.07, p=0.015), MI area(OR 0.41, 95% CI 0.18-0.85, p=0.023), MI diameter(OR 2.45, 95% CI 1.16-5.34, p=0.021), ALT(OR 0.98, 95% CI 0.97-0.99, p=0.002) and eGFR(OR 1.01, 95% CI 1.09-1.02, p=0.042) were significantly independent risk predictors of AF early recurrence. A predictive model was created with AUC of 0.720. Conclusions: BMI、LAD、MI area、MI diameter、ALT and eGFR were risk predictors of AF early recurrence. We established a predictive model and it devote to preoperative clinical health management of individual with valvular AF.