Clinical efficacy and prognosis of single radiofrequency ablation and left atrial appendage closure one-stop treatment in patients with atrial fibrillation

Abstract

Objective To compare and analyze the clinical efficacy and prognosis of single radiofrequency ablation and left atrial appendage closure one-stop treatment in the treatment of patients with atrial fibrillation. Methods One hundred patients with atrial fibrillation hospitalized in the First Affiliated Hospital of Zhengzhou University from January to December of 2018 were enrolled and divided into control group (50 cases) and observation group (50 cases). Patients in control group only received single radiofrequency ablation, and patients in the observation group received radiofrequency ablation and left atrial appendage closure. All patients were treated with standardized oral anticoagulant drugs (warfarin, dabigatinide capsules or rivaroxaban tablets) and amiodarone after surgery. The perioperative complications of the two groups were observed to evaluate the clinical efficacy and safety of the two treatment methods. The adverse events of the two groups 1 month, 3 months, 6 months and 12 months after surgery and left atrial appendage closure device of observation group were recorded in order to compare the clinical prognosis of the two groups and further evaluate clinical efficacy and success rate of left atrial appendage closure one-stop treatment. Results There was no statistically significant difference in the incidence of perioperative complications between the two groups (P>0.05). During the follow-up period, the incidence of bleeding and stroke/transient ischemic attack (TIA) in control group was higher than that in the observation group, and the difference was statistically significant (P 0.05). Residual leakage of the closure device occurred in 8 patients in the observation group. After 1 year of follow-up, residual leakage disappeared in 3 patients and significantly decreased in the remaining 5 patients, and the difference was statistically significant (P<0.05). Conclusions Compared with single radiofrequency ablation, left atrial appendageclosure one-stop treatment can effectively reduce the incidence of bleeding and stroke/TIA, with high safety, good clinical efficacy and prognosis in nonvalvular atrial fibrillation patients who have symptoms and high risk of stroke, however, do not want to take oral anticoagulants for a long time. Key words: Atrial fibrillation; Radiofrequency ablation; Left atrial appendage closure; One-stop treatment