Dissertation
Dissertation > Medicine, health > Internal Medicine > Heart, blood vessels ( circulatory ) disease > Heart disease > Arrhythmia > Atrial fibrillation and atrial flutter

The amplitude of F wave on the value of persistent atrial fibrillation radiofrequency ablation prediction of recurrence after

Author YuMin
Tutor FangQuan
School Beijing Union Medical College
Course Clinical
Keywords Persistent atrial fibrillation atrial fibrillation wave amplitude of radiofrequency catheterablation of atrial fibrillation recurrence rate
CLC R541.75
Type PhD thesis
Year 2012
Downloads 30
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BackgroundAtrial fibrillation (AF) is one of the most common clinical arrhythmia. Although radiofrequency catheter ablation for the treatment of atrial fibrillation in recent years continues to mature and develop, but some patients treated with radiofrequency ablation still recurred atrial fibrillation, persistent atrial fibrillation recurrence rate was high. Looking for indicators to predict the recurrence of persistent atrial fibrillation after radiofrequency ablation is important guiding significance for clinical work.ObjectivesInvestigate surface ECG F-wave amplitude of patients with persistent AF to predict atrial fibrillation recurrence ratio after radiofrequency ablation.MethodsRetrospective study patients with persistent atrial fibrillation who had taken radiofrequency catheter ablation at the Beijing Union Medical College Hospital Department of Cardiology,from November2006to February2012Collecte the information of clinical data, analysis the lead Ⅰ, lead aVF and lead V1F wave amplitude before radiofrequency catheter ablation. Follow-up these patients after radiofrequency ablation,and make sure if atrial fibrillation recurred. Analysis of the F wave amplitude and find the relationship between F wave amplitude and atrial fibrillation recurrence.ResultsF wave amplitude mean in lead I is0.057±0.012(0.033-0.091)mv. F wave amplitude mean in lead aVF is0.098±0.031(0.060-0.209)mv, F wave amplitude mean in lead V1is0.133±0.043(0.082-0.271)mv,the tatoal average of F wave amplitude0.096±0.025(0.058-0.185)mv50patients were followed up by25.2±18.5(4-68) months,24cases had atrial fibrillation recurrence, the recurrence ratio is48%.Compare the atrial fibrillation recurrence ratio between different F-wave amplitude size group:Divided by0.1mv:in lead aVF, the atrial fibrillation recurrence ratio of Fine AF group is62.5%, the atrial fibrillation recurrence ratio of Corase AF group is22.2%, P=0.006; in lead V1, the atrial fibrillation recurrence ratio of Fine AF group is75.0%, the atrial fibrillation recurrence ratio of Corase AF group is39.7%, P=0.032; in the total average F-wave amplitude group, the atrial fibrillation recurrence ratio of Fine AF group is60.1%, the atrial fibrillation recurrence ratio of Corase AF group is23.5%, P=0.013.Divided by the Median boundary:in lead aVF, the atrial fibrillation recurrence ratio of Fine AF group (<0.093mv)is72%, the atrial fibrillation recurrence ratio of Corase AF group (>0.093mv) is24%, P=0.002; in lead V1, the atrial fibrillation recurrence ratio of Fine AF group (<0.075mv) is64.0%, the atrial fibrillation recurrence ratio of Corase AF group is32%, P=0.024; in the total average F-wave amplitude group, the atrial fibrillation recurrence ratio of Fine AF group (<0.089mv) is72%, the atrial fibrillation recurrence ratio of Corase AF group (>0.089mv)is24%, P=0.001;in lead I there is no significant differences between the atrial fibrillation recurrence ratio of Fine AF group (<0.054mv) and Corase AF group(>0.054mv)Divided by the Quartile boundary:in lead aVF,0.075,0.093,0.105mv (25%,50%,75%), the atrial fibrillation recurrence ratio of Fine AF group is69.2%, the atrial fibrillation recurrence ratio of Corase AF group (>0.105mv) is15.4%, P=0.005; in lead V1,0.101,0.123,0.152mv (25%,50%,75%), the atrial fibrillation recurrence ratio of Fine AF group (<0.123mv) is64.0%, the atrial fibrillation recurrence ratio of Corase AF group is15.4%, P=0.005; in the total average F-wave amplitude group,0.081,0.089,0.107mv (25%,50%,75%), the atrial fibrillation recurrence ratio of Fine AF group (<0.081mv) is76.9%, the atrial fibrillation recurrence ratio of Corase AF group (>0.107mv)is23.1%, P=0.006; in lead I,0.047,0.054,0.064(25%,50%,75%), there is no significant differences between the atrial fibrillation recurrence ratio of Fine AF group (<0.047mv) and Corase AF group (0.064mv)F-wave amplitude as a indicator to predict the recurrence of atrial fibrillation:F-wave amplitude in lead aVF,choose cut-off point0.0934, to predict recurrence of atrial fibrillation sensitivity of73.1%, specificity75.0%; in lead V1, choose cut-off point0.1248to predict recurrence of atrial fibrillation sensitivity of65.4%, specificity70.8%; in the the total average group,choose cut-off point0.0895, to predict recurrence of atrial fibrillation sensitivity73.1%, specificity75.0%.ConclusionF-wave amplitude of the RF ablation in patients with persistent atrial fibrillation recurrence of atrial fibrillation, coarse wave of atrial fibrillation in patients with atrial fibrillation recurrence rate is significantly lower than the fine wave of patients with atrial fibrillation.F-wave amplitude in lead aVF, V1in patients with persistent atrial fibrillation after radiofrequency ablation in predicting recurrence of atrial fibrillation reference value.

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