To investigate the efficacy after linear ablation of the circumferential pulmonary vein in patients with atrial fibrillation. Methods We analyzed the data of 35 patients with atrial fibrillation who underwent circumferential pulmonary vein linear ablation and the follow-up at 3, 6 and 12 months after the procedure. The mean ventricular rate, left ventricular internal diameter (LVEDD), and left atrial internal diameter (LAD) decreased and left ventricular ejection fraction (LVEF) increased significantly in the 27 patients with successful surgery before and after surgery. Conclusion The circumferential pulmonary vein linear ablation procedure for the radical treatment of atrial fibrillation can interrupt the mechanism of atrial fibrillation and effectively reverse left atrial remodeling. 1. data and methods 1. 1 Case selection From December 2007 to December 2010, 35 patients with atrial fibrillation underwent circumferential pulmonary vein linear ablation under the guidance of the three-dimensional cardiac electroanatomical marker system (CARTO XP system). 23 males and 12 females, aged 45-72 years, mean (54.5±7.4 years), had paroxysmal atrial fibrillation in 23 cases. There were 23 cases of paroxysmal AF, 8 cases of persistent AF, and 4 cases of permanent AF with a history of 1-12 years, and all of them had panic, shortness of breath, and chest tightness. Paroxysmal AF was defined as AF that could be automatically resuscitated, persistent AF was defined as AF that lasted for more than 7 days and could be resuscitated by medication or direct current, and permanent AF was defined as those with failed resuscitation or no indication for resuscitation. There were 12 cases of combined organic heart disease, including 7 cases of coronary artery disease and 5 cases of hypertensive left ventricular hypertrophy. The New York Heart Association (NYHA) class 3 was used in 4 cases, and all were treated accordingly before surgery. 1. 2 Methods On admission, in addition to routine examination, 24-hour ambulatory ECG and transthoracic cardiac ultrasound should be done for pre- and post-treatment control. The heart rate was taken as the mean ventricular rate calculated by 24-hour ambulatory electrocardiogram. Congenital heart disease and heart valve disease were excluded by cardiac ultrasound, and left ventricular internal diameter (LVEDD), left atrial internal diameter (LAD) and left ventricular ejection fraction (LVEF) were measured, and the above indexes were reviewed at 3, 6 and 12 months after discharge. In all cases, atrial thrombus was ruled out by esophageal ultrasonography before surgery. For those who were already taking warfarin or aspirin, they stopped taking it for at least 5 days before surgery and replaced it with subcutaneous injection of low-molecular-weight heparin calcium until 1 day before surgery. 35 cases underwent three-dimensional reconstruction of the left atrium under CARTO calibrations using a special calibrated and ablation catheter with a 4-mm apical electrode, and were instructed to perform circumferential pulmonary vein vestibular ablation (CPVA). After completion of the preset ablation line, a loop Lasso electrode was delivered to further guide patch-point ablation on the CPVA ablation line with the ablation endpoint of bilateral pulmonary vein isolation. 1. 3 Statistical methods SPSS 10.0 statistical software package was applied to process the data, and the measurement data were expressed as mean ± standard deviation ( X ± s ). All patients had bilateral electrical isolation of pulmonary veins by CPVA. 21 patients were converted to sinus rhythm after ablation, and 3 patients with paroxysmal atrial fibrillation with intraoperative typical atrial flutter underwent ablation of the tricuspid annulus after CPVA to achieve bidirectional isthmus conduction block. 10 patients with persistent or permanent atrial fibrillation underwent simultaneous ablation of the left atrial apex and the second and third valves. One patient with persistent atrial fibrillation was converted to left atrial flutter during interval fracture potential ablation, and the flutter was terminated by continued ablation. one patient with permanent atrial fibrillation had persistent atrial fibrillation after completion of the preset ablation line, and was converted to sinus rhythm by electrical cardioversion. 2. 2 Postoperative management and follow-up All patients continued to take antiarrhythmic drugs for 2 months after the procedure, after which the drugs were discontinued to observe the ablation effect. In case of recurrence of AF during this period, antiarrhythmic drugs were given to revert AF. All patients were given subcutaneous injection of low-molecular-weight heparin after surgery, and warfarin was added until the international normalized ratio (INR) reached 2.0-3.0, then the low-molecular-weight heparin was stopped and warfarin anticoagulation therapy was continued. Warfarin was discontinued after at least 3 months of postoperative oral warfarin anticoagulation without atrial arrhythmia episodes. If atrial arrhythmias still occur, warfarin will be used according to the indication for anticoagulation. Maintain INR between 2.0 and 2.5. Success criteria: absence of any symptomatic atrial arrhythmias such as atrial fibrillation, atrial flutter or atrial tachycardia (excluding atrial precontraction) without any antiarrhythmic drugs from 3 months after ablation until completion of follow-up. Follow-up included 12-lead ECG and 24-hour ambulatory ECG at 3, 6 and 12 months postoperatively for atrial arrhythmia episodes and transthoracic cardiac ultrasound. 2. 3 Follow-up results 21 cases (60%) were in sinus rhythm without atrial arrhythmias at 3 months postoperatively. Atrial arrhythmias were observed in 14 cases. After 3 months, atrial fibrillation disappeared in 6 cases and antiarrhythmic drugs were discontinued, while 6 cases still had atrial fibrillation and 2 cases had left atrial flutter. There was no discomfort and the patients resumed normal work and study. There was no adverse drug reaction. The mean ventricular rate (HR), LVEDD, and LAD were significantly reduced, and LVEF was significantly increased.