Evaluation of Efficacy and Long-term Results of Catheter Ablation in Drug-refractory Atrial Fibrillation

房颤治疗是预防脑梗死和维持生活质量的重要心律失常。抗心律失常药物有时对房颤无效。射频导管消融（CA）是治疗此类房颤的有效方法。然而，不同机构对CA后房颤复发的评估存在差异。我们利用患者激活事件心电图仪（EvR）进行家庭监测，并将EvR与常规方法进行比较。EvR是检测房颤尤其是无症状房颤的有效工具，但传统方法低估了房颤复发率。房颤CA后房颤复发的预测因子为房颤类型、基础疾病、左心房大小和CHADS2-VASc评分。我们得出结论，对于CHADS2-VASc评分较低且无结构性心脏病的房颤患者，在房颤早期、左心房负荷较轻的时期，房颤CA治疗更为有效。这类患者CA后房颤的风险控制也很重要。

Treatment of atrial fibrillation(AF) is important arrhythmia for prevention of cerebral infarction and maintenance of QOL. AF is sometimes refractory to antiarrhythmic drugs. Radiofrequency catheter ablation(CA) is a curative method for such AF patients. However, evaluation of AF recurrence after CA is variable among institutions. We utilized home monitoring with patient's activating event ECG recorders(EvR), and compared EvR with conventional methods. EvR was very useful tool for detection of AF, especially asymptomatic AF. Conventional methods underestimated AF recurrence rate than EvR ECGs. Predictors of AF recurrence after CA of AF were AF type, underlying diseases, left atrial size, and CHADS2-VASc score. We conclude that CA for AF is more effective when performed early AF stage, during the periods with less load to the left atrium in low CHADS2-VASc score AF patients without structural heart disease. Risk control of AF is also important after CA in such patients.