Q: What is atrial fibrillation? A: Atrial fibrillation, referred to as atrial fibrillation, is the most common persistent arrhythmia, the overall incidence of atrial fibrillation is 0.7-1%, the incidence of atrial fibrillation increases with age, up to 10% of people over 75 years old. The frequency of atrial excitation in atrial fibrillation reaches 350-600 beats/min. The heart rate is often fast and irregular, sometimes reaching 150-200 beats/min. Not only is the heart rate much faster than normal, but it is absolutely irregular and the atria lose their effective contraction function. Common clinical symptoms of atrial fibrillation include: 1. palpitations: feeling a disturbed or accelerated heartbeat, physical fatigue or exertion; 2. vertigo: dizziness or fainting; 3. chest discomfort: pain, pressure or discomfort; 4. shortness of breath: feeling breathless during mild physical activity or at rest; in addition some patients may not have any symptoms. Atrial fibrillation hazards: Atrial fibrillation when the atria lose contraction function, blood is easy to stagnate in the atria and form thrombus, the thrombus can be dislodged with the blood to all parts of the body, leading to brain embolism (stroke), limb artery embolism (serious cases even require amputation) and so on. Risk factors for stroke in patients with atrial fibrillation include previous history of embolism, hypertension, diabetes, coronary artery disease, heart failure, left atrial enlargement, and age over 65 years. Loss of atrial systolic function and prolonged increase in heart rate in atrial fibrillation can lead to heart failure and increased mortality (two times the normal rate). Q: What is catheter ablation for atrial fibrillation? Some studies have shown that at least about 95% of paroxysmal atrial fibrillation is closely related to the pulmonary veins of the left atrium. Typically humans have four pulmonary veins that converge from the posterior part of the left atrium of the heart; a few patients can have more or less than four. Catheterized radiofrequency ablation is performed by delivering a 2.67 mm diameter radiofrequency ablation catheter into the left atrium through the peripheral venous vessels. High frequency electromagnetic waves, or radiofrequency energy, are delivered at the site where the atrium joins the pulmonary veins, ablating the pulmonary veins for one week along the opening of the pulmonary veins. The abnormal excitation of the pulmonary vein is blocked in the pulmonary vein so that it cannot be transmitted to the left atrium, thus achieving the goal of atrial fibrillation eradication. In persistent atrial fibrillation, the ablation procedure is more complex, but is confined to the atria. Radiofrequency ablation of atrial fibrillation is an interventional procedure that is minimally invasive, with only two puncture points in the right and left femoral veins (root of the thigh). The procedure is performed under local anesthesia and the patient is awake throughout the procedure. Most patients may have a slight burning sensation during the ablation, but it is mostly tolerable. After the procedure, patients need to lie down for 12 hours and can get out of bed and be observed for 1 day. Patients with no recurrence and no complications can be discharged. Q: Which patients are suitable for catheter ablation? A: Atrial fibrillation that are more suitable for radiofrequency ablation are: 1, patients with atrial fibrillation without underlying heart disease, so-called isolated atrial fibrillation or idiopathic atrial fibrillation; 2, patients with well-controlled hypertension combined with atrial fibrillation; 3, patients with atrial fibrillation after thyroid abnormalities have been controlled (better after 6 months of control). The above-mentioned part of patients with mild underlying heart disease, relatively speaking, atrial fibrillation may bring greater harm, and the implementation of radiofrequency ablation has low risk and high benefit, so it is recommended that radiofrequency ablation is preferred for these types of patients. Indications for radiofrequency ablation: 1) atrial fibrillation with combined coronary artery disease, after adequate anti-myocardial ischemic treatment; 2) atrial fibrillation with combined hypertrophic cardiomyopathy; 3) atrial fibrillation after valve replacement for rheumatic valve disease; 4) atrial fibrillation with heart failure; these patients have more serious heart disease, and the risk of surgery is high, but the harm of hemodynamic disturbance brought by atrial fibrillation for these patients is Considering that AF correction may bring great benefits to patients, it can be an indication for RF ablation. Q: What are the risks of catheter ablation of atrial fibrillation? A: Overall, radiofrequency ablation of atrial fibrillation catheters is a relatively safe procedure. However, as with other invasive operations, there are risks associated with atrial fibrillation radiofrequency ablation. The most serious complications include: 1. Pericardial tamponade: i.e., perforation of the atrium during surgery. Although this complication is dangerous, it can be lifted by pericardial puncture and drainage or surgical hemostasis; 2, cerebral infarction: the main reason is that there is a thrombus in the atrium of the patient before surgery, or the thrombus is formed because the mechanical contraction of the atrium has not fully recovered after surgery. This complication can be reduced by strict and careful transesophageal echocardiography and perioperative anticoagulation before the procedure; 3. Some other complications are the same as common RF ablation treatment, but the complications can be reduced by some preventive measures. Q: What is the success rate of atrial fibrillation catheter ablation and the factors affecting the success rate? A: The success rate of a single radiofrequency ablation procedure in patients with paroxysmal atrial fibrillation is about 90%, while the success rate of a single procedure in patients with persistent or persistent atrial fibrillation is about 80%, and the cumulative success rate after the second or third procedure can reach 90%. The anatomical morphology of the patient’s heart will affect the smoothness of the surgical operation and is related to the success rate of the procedure. A number of clinical factors also influence the success rate of the procedure, such as age, duration of disease, type of atrial fibrillation, left atrial size, hypertension, sleep apnea, and obesity. Q: Evaluation of the success of radiofrequency ablation of atrial fibrillation? A: Treatment success: is defined as the absence of atrial fibrillation, atrial flutter or atrial tachycardia episodes without the use of drugs for atrial fibrillation 3 months after the procedure. If antiarrhythmic drugs are used after surgery, the judgment time should be after 5 half-lives of antiarrhythmic drugs or after 3 months of amiodarone discontinuation. Effective treatment: It refers to the absence of atrial fibrillation, atrial flutter or atrial tachycardia after ablation with the use of preoperative antiarrhythmic drugs that are ineffective; or the number of atrial fibrillation episodes is significantly reduced or the duration is significantly shortened after ablation. Early recurrence: Atrial fibrillation/atrial flutter/atrial tachycardia occurring within 3 months after ablation, if the duration is ≥30s, is considered as early recurrence. It was observed that about 60% of early recurrences would disappear on their own. Late recurrence: Atrial fibrillation/atrial flutter/atrial tachycardia occurring 3 months after ablation, if the duration is ≥30 s, are considered as late recurrence. Some people designate recurrences after 12 months of ablation as more distant recurrences.