Radiofrequency catheter ablation of atrial fibrillation in old patients

Objective To analyze the efficacy of different radiofrequency catheter ablation techniques in treatment of atrial fibrillation in old patients.Methods Consecutive 53 patients(60-83 years,38 men) were divided into 3 groups according to different ablation techniques used.Group 1 had 20 patients with paroxysmal atrial fibrillation who underwent the ablation technique of isolating pulmonary veins,group 2 had 26 patients with typical atrial flutter and atrial fibrillation who underwent ablation of typical atrial flutter,and group 3 had 7 patients with drug-resistant persistent atrial fibrillation who underwent ablation of atrioventricular(AV) conduction and implantation of permanent pacemaker.Results In group 1,15 patients underwent isolation of 3-4 pulmonary veins under the direction of LASSO mapping catheter,and 8 of them(53%) had no atrial fibrillation after ablation.Five patients in group 1 underwent complete isolation of left atrium surrounding the pulmonary veins using the double-Lasso technique,and 4 of them(80%) had no atrial fibrillation after ablation.All the 26 patients in group 2 had successful ablation of typical atrial flutter,and 15 of them(58%) had no atrial fibrillation during follow-up.Eight of the 26 patients(31%) had significant decrease in the frequency of atrial fibrillation.After successful ablation of AV conduction in group 3,4 and 3 patients received respectively implantafion of right ventricular and biventricular pacing of VVI mode,and all of them had significant improvement in the quality of life and/or the symptoms of heart failure.Conclusion Different radiofrequency catheter ablation techniques had good clinical effects on different types of atrial fibrillation in old patients.