Purpose: Coronary artery disease (CAD) and atrial fibrillation (AF) often coexist and lead to a much higher risk of mortality in the elderly population. The aim of this study was to investigate whether the CHA2DS2-VASc score could predict the risk of death in elderly patients with CAD and AF. Methods: Hospitalized patients aged ≥65 years with a diagnosis of CAD and AF were recruited consecutively. Patients were divided into 5 groups according to the CHA2DS2-VASc score (≤2, =3, =4, =5, and ≥6). At least a 1-year follow-up was carried out for the assessment of all-cause death. Results: A total of 1,579 eligible patients were recruited, with 582 all-cause deaths (6.86 per 100 patient-years) occurring during a follow-up of at least 1 year. With the increase in the CHA2DS2-VASc score, the 1-year and 5-year survival rate decreased (96.4% vs. 95.7% vs. 94.0% vs. 86.5% vs. 85.7%, respectively, P < 0.001; 78.4% vs. 68.9% vs. 64.6% vs. 55.5% vs. 50.0%, respectively, P < 0.001). Compared with the patients with CHA2DS2-VASc score <5, for patients with CHA2DS2-VASc score ≥5, the adjusted hazard ratio for death was 1.78 (95% CI: 1.45–2.18, P < 0.001). The predictive values of the CHA2DS2-VASc score ≥5 for in-hospital (C-index = 0.66, 95% CI: 0.62–0.69, P < 0.001), 1-year (C-index = 0.65, 95% CI: 0.63–0.67, P < 0.001) and 5-year (C-index = 0.60, 95% CI: 0.59–0.61, P < 0.001) death were in comparable. Conclusion: In elderly patients with concomitant CAD and AF, the CHA2DS2-VASc score can be used to predict death with moderate accuracy.

Background. This study aimed to analyse the role of the HAS-BLED score with the addition of genotype bins for bleeding risk prediction in warfarin-treated patients with atrial fibrillation (AF). Methods and Results. Consecutive patients with AF on initial warfarin treatment were recruited. For each patient, CYP2C9∗3 and VKORC1-1639 A/G genotyping was performed to create 3 genotype functional bins. The predictive values of the HAS-BLED score with or without the addition of genotype bins were compared. According to the carrier status of the genotype bins, the numbers of normal, sensitive, and highly sensitive responders among 526 patients were 64 (12.17%), 422 (80.23%), and 40 (7.60%), respectively. A highly sensitive response was independently associated with clinically relevant bleeding (HR: 3.85, 95% CI: 1.88–7.91, P=0.001) and major bleeding (HR:3.75, 95% CI: 1.17–11.97, P=0.03). With the addition of genotype bins, the performance of the HAS-BLED score for bleeding risk prediction was significantly improved (c-statistic from 0.60 to 0.64 for clinically relevant bleeding and from 0.64 to 0.70 for major bleeding, P<0.01). Using the integrated discriminatory, net reclassification improvement, and decision curve analysis, the HAS-BLED score plus genotype bins could perform better in predicting any clinically relevant bleeding than the HAS-BLED score alone. Conclusions. Genotypes have an incremental predictive value when combined with the HAS-BLED score for the prediction of clinically relevant bleeding in warfarin-treated patients with AF.

目的 研究心电图aVR与aVL导联的QS波振幅比值鉴别右室流出道室性心律失常起源前后侧的意义.方法 回顾性分析2009年至2019年在解放军总医院第一医学中心行导管射频消融的且靶点在右室流出道的室性心律失常患者87例的临床资料.根据术中右前斜30°X射线投射下的消融靶点位置,将手术患者划分为2组:前侧组(n=52)和后侧组(n=35).测量2组患者室性心律失常发作时心电图的aVR与aVL导联QS波振幅,分析QS波振幅比值QSavR/QSaVL与消融靶点位置前后的关系.采用SPSS 24.0软件进行统计分析.采用受试者工作特征(ROC)曲线计算QSaVR、QSaVL、QSavR/QSaVL对RVOT起源点前后侧预测的灵敏度与特异度,采用曲线下面积(AUC)对比其准确性.结果 QSaVR/QSaVL在右室流出道前侧显著小于后侧[(1.25±0.81)和(2.13±1.16),P＜0.001].ROC曲线结果显示,3个指标中QSaVR/QSaVL(0.786)的AUC大于QSaVL(0.724)和QSavR(0.649);当QSaVR/QSaVL截断点取1.48时,约登指数最大(0.54),此时预测右室流出道前侧靶点的灵敏度为0.83,特异度为0.71.结论 aVR/aVL导联QS波振幅比对于鉴别右室流出道室性早搏起源的前后侧有一定指导意义.

Introduction: Personalized antiplatelet treatment in patients with acute coronary syndrome (ACS) or undergoing percutaneous coronary intervention (PCI) remains challenging in clinical practice. The present study aimed to explore the benefit of genotype-guided antiplatelet treatment with P2Y12 inhibitors in patients with ACS or undergoing PCI. Methods: A literature search was conducted (from inception to September 2018) in the PUBMED, EMBASE and Cochrane databases. Studies were included in which the genotype-guided P2Y12 inhibitor antiplatelet strategy was compared with the standard strategy in patients with ACS or undergoing PCI. The endpoints were high on-treatment platelet reactivity (HTPR), major adverse cardiovascular events including all-cause mortality, myocardial infarction (MI), stent thrombosis (ST), stroke and target-vessel revascularization (TVR), and major bleedings. Results: A total of 3377 patients in 9 studies (5 RCTs and 4 non-RCTs) were included, in which 91% of the patients were diagnosed with ACS and 88.5% underwent PCI. A total of 1639 patients (48.5%) were assigned to the genotype-guided group, and 1738 (51.4%) assigned to the conventional or standard (STD) group, with an average follow-up time of 7.6 months. After the pooled analysis, significantly lower risks of HTPR (HR: 0.32, 95% CI: 0.18-0.55, P < 10(-4)), all-cause mortality (HR: 0.55, 95% CI: 0.37-0.83, p = 0.005), MI (HR: 0.43, 95% CI: 0.27-0.67, p = 0.0002) and ST (HR: 0.39, 95% CI: 0.16-0.97, p = 0.004) were observed in the geno-type-guided group compared to the STD group. No significant between-group difference was found for the risk of stroke, TVR, and major bleedings after the pooled analysis. Conclusion: Genotype-guided antiplatelet treatment could decrease the risks of HTPR, all-cause mortality, MI and ST in patients with ACS or undergoing PCI.

目的 探究线粒体转运RNA(tRNA)基因突变与母系遗传原发性高血压(EH)的关联性.方法 依据EH诊断和母系遗传判别标准,筛选2015年1月至2018年12月解放军总医院心血管内科收治的母系遗传EH患者17例(A组)、非母系遗传EH患者65例(B组).选取同期来院进行健康体检的正常对照人群33名(C组).对全线粒体DNA(mtDNA)进行测序并与线粒体基因文库MitoMap的修正剑桥序列进行比对,分析3组受试者线粒体tRNA基因突变率差异及其与母系遗传EH发生的关系.应用SPSS 19.0软件对数据进行分析.结果 纳入人群中母系遗传EH占总EH 20.7％(17/82).mtDNA序列对比分析发现,与C组(0.04％)比较,A组(0.28％,P=0.024)及B组(0.12％,P=0.046)患者线粒体tRNA基因总变异率明显升高,但A与B组间比较差异无统计学意义(P=0.076).对A组患者进一步分析显示,仅有1个线粒体tRNA基因位点突变的先证者A06、A11和A13所在3个家系分别发生mtDNA A5823G、mtDNA T4386C与mtDNA C15910T突变,三个家系母系成员EH发病率分别为53.8％(7/13)、87.5％(7/8)和75.0％(9/12),发病率均较高,提示这3个位点突变可能与母系遗传EH发生密切关联.另外,mtDNA 5597缺失在A组(4例,23.5％)、B组(14例,21.5％)和C组(1例,3.0％)均出现.与C组比较,A组(P=0.002)与B组(P=0.002)患者mtDNA 5597缺失率均显著升高,但A组与B组间比较差异无统计学意义(P=0.127).结论 mtDNA A5823G、mtDNA T4386C与mtDNA C15910T突变与母系遗传EH有较好的关联性,但mtDNA 5597缺失与母系遗传EH关系不大.

The mitochondrial genotype 5178 cytosine/adenine (5178 C > A) within the NADH dehydrogenase subunit-2 gene (ND2) was proved to associate with longevity and predispose resistance to adult-onset diseases. This study aimed to confirm the interactive effects between ND 25178 C > A and clinical risk factors on the susceptibility of essential hypertension in Chinese general population. The relationship between the ND2 5178 C > A variation and the risk of hypertension was investigated in 817 hypertensives and 821 matched normotensives. The interactive effects between ND2 5178 C > A and clinical risk factors were evaluated. The ND2 5178 A allele was more frequent in normotensives than in hypertensives (32.64% vs. 24.24%; adjusted OR: 0.62, 95% CI: 0.49–0.79, P = 1.3 × 10− 4). After stratification, the significant association between ND2 5178 C > A and hypertension was found only in current smokers (OR: 0.44, 95% CI: 0.31–0.62), but not in non-current smokers (p <  0.01 for interaction). Smoking status (OR: 1.51, 95% CI: 1.11–2.06) and high triglycerides (OR: 1.57, 95% CI: 1.10–2.24) were found independently associated with hypertension only in carriers of 5178 C allele but not in carriers of 5178 A allele. In conclusion, ND2 5178 A allele could confer a lower risk for essential hypertension in Chinese by the interaction with smoking status. The higher risk of hypertension imposed by smoking and high TG may be altered by ND2 5178 A allele.

目的 探讨心血管植入式电子器械(CIEDs)患者三尖瓣反流加重的影响因素及可能的发生机制.方法 回顾性收集解放军总医院第一医学中心心血管内科2014年1月至2016年12月所有植入CIEDs(单腔或双腔永久式起搏器、埋藏式心律转复除颤器及心脏再同步化治疗)后复查心脏彩超的198例患者的临床资料.根据术后三尖瓣反流是否加重分为三尖瓣反流未加重组146例和加重组52例,比较2组患者的临床资料及术前心脏彩超资料.采用SPSS 17.0软件对数据进行统计学处理.组间比较采用Mann-Whitney U检验、非配对χ2检验或Fisher精确概率法.采用多因素logistic逐步回归法分析三尖瓣反流加重的相关危险因素.结果 与未加重组比较,加重组患者男性、术前肌酐清除率、高脂血症及植入时间>12个月的的患者比例升高,术前右心房内径较小、二尖瓣及三尖瓣存在反流的患者比例较低,差异有统计学意义(P<0.05).多因素logistic回归分析表明,植入时间(OR=1.000,95％CI 1.001～1.003;P=0.013)和高脂血症(OR=2.024,95％CI 6.728～22.360;P=0.022)可能是三尖瓣反流加重的独立危险因素;术前存在轻度三尖瓣反流(OR=0.018,95％CI 0.049～0.133;P<0.001)可能是三尖瓣反流加重的独立保护因素.结论 起搏器植入时间、高脂血症可加重三尖瓣反流,术前三尖瓣反流程度与术后三尖瓣反流加重相关,应注意随访观察.

目的 比较房颤患者中3种不同环肺静脉前庭射频消融路径的消融成功率.方法 回顾性分析解放军总医院心血管内科2015年6月至2017年6月住院房颤患者173例,根据射频消融线所在区域分为心房前庭组61例、肺静脉前庭组47例和前庭组65例,比较3组患者手术时间、X线曝光时间和消融时间,以及穿刺房间隔后、术后即刻和术后24 h血浆中C反应蛋白(CRP)、氨基末端B型脑钠肽前体(NT-proBNP)和白细胞介素-6(IL-6)水平.应用SPSS 17.0统计软件对数据进行分析.组间比较采用单因素方差分析、秩和检验或χ2检验.结果 所有患者在消融过程中达到完全电隔离的即刻成功率为84.39％(146/173).心房前庭组患者消融时间明显长于肺静脉前庭组患者[(120.67±13.12)vs(90.17±6.95)min],差异有统计学意义(P<0.05).相比穿刺房间隔后,3组患者术后即刻和术后24 h IL-6水平升高,肺静脉前庭组患者术后24 h NT-proBNP水平升高;肺静脉前庭组患者术后24h CRP水平相比心房前庭组患者[(1.99±1.09)vs(0.40±0.29)mg/L]升高,差异均具有统计学意义(P<0.05).161例随访12个月,12例失访,失访率为6.94％(12/173).27例房颤复发,手术成功率为83.23％(134/161),其中心房前庭组手术成功率[89.83％(53/59)vs 73.33％(33/45)]高于肺静脉前庭组,差异具有统计学意义(P<0.05).结论 房颤患者不同环肺静脉前庭射频消融路径中,心房前庭侧消融路径优于肺静脉前庭消融路径.

Objective To evaluate the efficacy of figure 8 suturing technique in treatment of tunnel bleeding after femoral artery puncture.Methods A total of 152 patients,who had undergone transfemoral percutaneous coronary intervention and then developed bleeding after catheter insertion,admitted in our department from December 2013 to December 2016 were enrolled in the study consecu-tively.These patients were assigned randomly into figure 8 suturing group(n=63)and strengthened compression group(n=89). Five parameters,including mean compression time,bandaging frequency,mean operation time,incidence rate of lower limb deep vein thrombosis(DVT),and length of hospital stay after operation,were compared between the 2 groups.SPSS statistics 22.0 was used to perform the statistical analysis, and Student′s t test or Chi-square test was employed to make comparison for different data types. Results Compared to the strengthened compression group,the figure 8 suturing group had shorter compression time[(22.3 ±5.4)vs (26.8 ±6.8)h, P<0.01], less bandaging frequency[(2.1 ±0.7)vs(2.6 ±1.1)times, P <0.01], shorter operation time [(8.9 ±2.5)vs(12.3 ±4.1)min,P<0.01], lower incidence rate of DVT(0.0% vs 6.7%, P<0.05), and shorter length of hospital stay[(3.5 ±1.2)vs(4.8 ±2.1)d,P<0.01].Conclusion Figure 8 suturing technique is effective and easy-to-operate in treatment of tunnel bleeding after femoral artery puncture,and obviously superior to conventional compression method.

Objective To review the teaching effect of 3-min+task teaching method on advanced students practicing in department of cardiology. Methods The advance students (n=72, male 32, female 40 and aged from 28 to 42) studied in the Department of Cardiology of Chinese PLA General Hospital were chosen from May 2013 to Apr. 2017. All students were randomly divided into control group and test group (each n=36). The control group was given clinical teaching with routine teaching method, and test group, additionally with 3-min+task teaching method. The results of theory, manipulation and comprehensive examinations were reviewed in 2 groups, and satisfaction of students' on clinical teaching and general evaluation of doctors' and nurses' without teaching tasks and patients' on students were surveyed by using questionnaire. Results Compared with control group, the results of theory and comprehensive examinations were significantly increased in test group [(81±16) vs. (90 ±18)] and [(79±15) vs. (91±19), all P<0.05]. Compared with control group, satisfaction was higher in test group [(3.2±1.4) vs. (4.5±1.1)], and general evaluation of doctors' and nurses' without teaching tasks increased in test group [(3.0±1.5) vs. (4.3±1.2)] and [(3.5±1.1) vs. (4.6±1.4), all P<0.05]. Conclusion The teaching method of 3-min+task is a simple, feasible and effective method for clinical teaching, which is worth to be popularized in clinical practical teaching.

Introduction: The SAMe-TT2R2 score has been proposed to predict whether patients with atrial fibrillation (AF) would be well anti-coagulated with warfarin or not. However, it might over-estimate the number of patients under suboptimal warfarin treatment in non-Caucasians. This study was designed to modify the SAMe-TT2R2 score with genotypes and validate it in Chinese AF patients treated with warfarin.Material and methods: Consented Chinese-Han patients (n= 510) with AF under the treatment of warfarin for at least 3 months were randomly divided into a derivation (n= 310) and a validation cohort (n= 200). For each patient, CYP2C9*3 and VKORC1-1639 A/G genotyping was performed, and the time in therapeutic range (TTR) was calculated over this period.Results: The modified SAMe-TT2R2 score was established by adding "warfarin genotype bins" to replace "the non-white race" variable. In the validation cohort, the discrimination performance of the modified score for good anticoagulation control (TTR >= 70%) was significantly improved (c-index increased from 0.60 to 0.67). Significantly increased risks of major bleedings (HR: 4.91; 95% CI: 1.03-23.37; adjusted p = 0.04) and all bleedings (HR: 1.93; 95% CI: 1.14-3.25; adjusted p = 0.01) were found in patients with modified scores = 2, as compared with patients with modified scores of 0-1.Conclusions: The modified SAMe-TT2R2 score could improve the ability for the identification of good anticoagulation control, and the prediction of major bleeding events in Chinese patients with AF treated by warfarin. (C) 2017 Elsevier B.V. All rights reserved.

Objective To investigate the safety and efficacy of mapping and ablating paroxysmal atrial fibrillation (PAF) by using remote magnetic navigation system (MNS, Niobe Ⅲ, Stereotaxis) vs manual navigation.Methods Totally 103 consecutive patients diagnosed as PAF in our department from October 2014 to November 2016 were enrolled in our study.They were randomly divided into MNS group [(n=53, 27 males and 26 females, at an age of (65±13) years] and manual navigation group [(n=50, 23 males and 27 females, at an age of (62±15) years].Procedure time, ablation time, X-ray exposure time, and recurrence in 3 months' follow-up were collected and compared between the 2 groups.Results Pulmonary vein isolation was accomplished in 52 cases from the MNS group, and in 49 cases of the manual navigation group.The success rate was 98% in both group, without significant difference (P>0.05).Compared with the manual navigation group, the MNS group had significantly longer procedure and ablation times, but obviously shorter X-ray exposure time (P<0.05).There was no notable difference in the recurrent rate between the MNS (10 cases) and manual navigation groups (12 cases) in 3 months after surgery (19% vs 24%, P>0.05).Conclusion In comparison with manual navigation, Niobe Ⅲ remote magnetic navigation system is safe and effective in mapping and ablation of PAF, and it reduces the X-ray exposure time.

Objective To analyze the risk factors for venous thrombosis related to the lead of cardiovascular implantable electronic device (CIED) in order to provide the theoretical basis for clinical prevention.Methods A total of 112 patients undergoing CIED implantation and with full follow-up data who hospitalized in our department from September 2013 to December 2015 were recruited in this study.According to the results of postoperative vascular ultrasound examination, they were assigned to the thrombosis group [n=56, at an age of (71.86±8.35) years] and the non-thrombosis group [n=56, at an age of (71.23±10.62) years].Their clinical data were collected and retrospectively analyzed.Multivariate logistic regression analysis was applied to assess the risk factors of the related venous thrombosis.Results There were significant differences in the numbers of patients with atrial fibrillation, those with implanted defibrillator leads and those taking anticoagulant medications, the left ventricular ejection fraction, the serum level of glycosylated hemoglobin, as well as the times of venipuncture, operation time, and lead numbers between the thrombosis and the non-thrombosis groups (P<0.05).Multivariate logistic regression analysis showed atrial fibrillation, times of venipuncture, operation time and lead numbers were the risk factors for the related venous thrombosis, and administration of anticoagulant medications was the protective factor.Conclusion Atrial fibrillation, times of venipuncture, operation time and lead numbers are the independent risk factors for venous thrombosis related to CIED leads.

Objective To investigate the efficacy and safety of mapping and ablating premature ventricular contractions (PVCs) originated from ventricular outflow tract using remote magnetic navigation system (MNS, Niobe III, Stereotaxis) vs. manual navigation.Methods 68 consecutive patients diagnosed as outflow tract PVCs from Oct 2014 to Jan 2017 were enrolled in our study, the mean age was 43±13 years and 38±12 years in MNS group and manual group, respectively. Mapping and ablating were performed by MNS or CARTO 3 system. The operative efficacy, safety and other relevant clinical data were compared between the two groups.Results There was no significant difference between two groups according to clinic profiles. The acute success rate was 93.9% (31/33)vs. 91.4% (32/35) (P>0.05), respectively. Total procedure time and ablation time was (125±45 minvs. 105±40 min, P>0.05), and (270±60 svs. 240±55 s,P>0.05), respectively. The power was much higher in MNS group than that in manual group (40±10 Wvs. 25±5 W, P<0.05). MNS group had less fluoroscopic time than manual group (1.2 ±0.5 minvs. 3.2±1.2 min,P<0.05). Both groups had no severe complications.Conclusion The Niobe III remote magnetic navigation system for mapping and ablation of outflow tract PVCs is effective and safe. Furthermore, it may reduce the exposure time from radiation for both patients and physicians. But higher power maybe needed.

BACKGROUND:Sympathetic nerves-fire rate is generally enhanced in some types of hypertension models. Renal sympathetic denervation(RSD) by the radiofrequency ablation was used to treat the hypertension has achieved curative effect.HTN-1 and HTN-2 trial reported catheter-based renal denervation may cause substantial and sustained blood-pressure reduction in patients with resistant hypertension. However, recent controlled HTN-3 trial questioned the BP lowering effect of Renal denervation treatment. The controversial results maybe arised from the incompleted RSD which implemented inside the renal artery. Now renal denervation therapy for resistant hypertension is in attractive and controversial status. Our aim is to define the hyotensive value of complete renal denervation in adult spontaneous hypertensive rats.METHODS:Male spontaneous hypertensive rats(SHR) aged 12 weeks were randomly selected for either unilateral renal artery sympathetic nerves ablation (URSNA), or conventional technique of renal denervation (CRD), or bilateral renal artery sympathetic nerves ablation (BRSNA) and sham operation. Blood pressure, sodium and water balance,serum reninangiotensin II and Norepinephrine concentration were measured during 20 weeks after renal denervation operation. Internal diameters of renal arteries and renal blood flow rate was tested by ultrasonic contrast imaging.RESULTS:The continued increased blood pressure in SHR was delayed and significantly reduced by conventional renal denervation over a period of 8 weeks. Both the bilateral and unilateral renal sympathetic nerve ablation procedure did not prevent the development of hypertension in SHR. The attenuation of hypertension was accompanied with the increase of urinary sodium excretion and depression of rennin angiotensin system (RAS).CONCLUSIONS:We concluded that renal denervation may not be an effective therapeutic method in the long-term control of hypertension in adult SHR.

Objective To assess the long-term efficacy of enhanced ablation in pulmonary vein antrum ( PVA) guided by remote magnetic navigation ( RMN) in the patients with atrial fibrillation ( AF) .Methods From January 2013 to June 2015, 49 consecutive patients with refractory non-valvular AF who undergoing radiofrequency catheter ablation and voluntarily taking part in this study in our hospital were recruited in this study .They were randomized into a conventional ablation group ( CAG, n =24 ) and an enhanced ablation group ( EAG, n=25) .PVA isolation was achieved by creating a single ablation circle in the patients of CAG group , and was double ablation circles at PVA in those of EAG group .An irrigated magnetic ablation catheter , CARTO 3 mapping system and Niobe magnetic navigation were used in both groups .A Lasso? mapping catheter was used to confirm PVA isolation.Regular Holter monitoring was used to follow up all patients .Results PVA isolation succeeded in all the patients .Ablation energy delivery time was obviously longer in EAG group than in CAG group [(45.66 ±6.59) vs (40.10 ±3.48) min, P<0.01].There were no significant differences in fluoroscopic time , procedure time and venous NT-proBNP level between the 2 groups ( P>0.05) .During the follow-up of (19.3 ±5.6) months, Holter monitoring showed that the AF recurrence rate was remarkably lower in EAG group than in CAG group (8.00%vs 33.33%, P<0.05).Reconnection between left atrium and PV was confirmed in 8 relapsed patients during re-ablation, and reoperation was successful in all of them .Conclusion Enhanced PVA ablation effectively improves the long-term outcomes of AF and reduces the recurrence rate .

目的 以冠状动脉造影“金标准”为依据,探讨应用热断层扫描成像(TTM)技术筛查冠心病的效果.方法 选择190例怀疑冠心病拟行冠状动脉造影检查的患者为研究对象,收集临床资料,完成心电图、超声心动图检查,盲法进行TTM扫描后,按照标准方法完成冠状动脉造影.结果 190例患者中,有心绞痛症状172例,心电图阳性发现88例,超声心动图阳性发现16例;冠状动脉造影显示冠心病患者130例;TTM提示心肌供血不足150例.应用TTM判断冠心病的灵敏度为100％,特异度为66.67％,正确率为89.47％.相对于临床症状、心电图和超声心动图检查三种方法来讲,TTM检查的灵敏度和正确率最高.并且,TTM可以判断心肌供血不足的程度.结论 TTM作为一项完全无创的检查不仅能够灵敏地筛查出冠心病患者,还能够反映出冠心病患者的病情严重程度.

Objective To investigate the relationship between pulmonary vein potential amplitude (PVPA) and ablation time in the treatment of atrial fibrillation (AF) with PVP guided radiofrequency ablation. Methods A total of 43 AF patients undergoing pulmonary vein isolation (PVI) in our department from January 2014 to June 2015 were recruited in this study. They were divided into paroxysmal AF group (n=34) and persistent AF group (n=9). PVPA, ablation time and recurrence rate in 12 months after treatment were compared between the 2 groups. Results There was a linear correlation between PVPA and ablation time, with the larger PVPA the longer ablation time. No significant difference was found in the PVPA and ablation time between the 2 groups (P>0.05). In 12 months after the treatment, the recurrence rate was 17.6% and 55.6%, respectively for the paroxysmal and persistent AF groups (P<0.05). Conclusion PVPA is an important index to direct radiofrequency ablation in PVI. But other AF ablation techniques should be used in the patients with persistent AF to improve long-term recurrence-free rate.