Objective To investigate the clinical characteristics and the risk factors for recurrence in patients coexist with paroxysmal atrial fibrillation and atrial flutter after non-pulmonary vein trigger isolation. Method This is a single-center, retrospective study. One hundred and seventy-nine patients with paroxysmal atrial fibrillation and atrial flutter who underwent catheter ablation from Jan 2017 to Jan. 2020 were enrolled in this study. All the patients received circumferential pulmonary vein antrum isolation (CPVI), with non-pulmonary vein trigger isolation if needed. They were divided into two groups depending on whether ablating the non-pulmonary vein triggers: only CPVI in the CPVI group (141cases, 78.77%), CPVI and non-pulmonary trigger ablation in the N-CPVI group (38 cases, 21.23%). The recurrence was evaluated at follow-up for 3-12 months after radiofrequency ablation. Multivariate Cox regression analysis was used to explore the risk factors for recurrence. Kaplan-Meier survival curve was used to compare the recurrence between the CPVI group and the N-CPVI group by Log-rank test. Results Compared with the CPVI group, the N-CPVI group had more hypertension (P=0.009) and diabetes (P=0.030), and the proportion of left atrial diameter >40 mm (P=0.010) and LVEDd >50 mm in N-CPVI group were higher (P=0.027). Kaplan Meier survival curve showed that the maintenance rate of sinus rhythm in the CPVI group was higher than that in the N-CPVI group after catheter ablation for patients with paroxysmal atrial fibrillation and atrial flutter (P=0.004). Multivariate COX regression analysis showed that hypertension (HR=3.38, 95%CI: 1.15~5.95, P=0.037) and ablation of non-pulmonary vein trigger focus (HR=1.37, 95%CI: 1.17~2.78, P=0.009) were independent risk factors for recurrence of patients with paroxysmal atrial fibrillation and atrial flutter after catheter ablation. Conclusion Non-pulmonary triggers ablation and hypertension had been found two independent risk factors associated with the recurrence of patients coexist with paroxysmal atrial fibrillation and atrial flutter after catheter ablation.
