Arterial thrombotic events, including acute coronary syndromes, remain the leading cause of morbidity and mortality worldwide. Platelet activation plays a crucial role in arterial thrombosis. The resolution of inflammation is an actively regulated physiological process driven by specialized pro-resolving mediators (SPMs). Resolvin D2 (RvD2), a core endogenous lipid mediator derived from docosahexaenoic acid (DHA), exhibits established protective effects in maintaining cardiovascular homeostasis and delaying atherosclerosis. However, the roles of RvD2 and its receptor GPR18 in platelet activation and arterial thrombosis remain largely unknown. In this study, we evaluated the effects of RvD2 on platelet activation and thrombosis using in vitro platelet function assays and an in vivo thrombosis model. In vitro assays demonstrated that RvD2 concentration-dependently (50, 100, 500 pg/mL) inhibited human platelet aggregation induced by thrombin, collagen, and ADP, and reduced ATP release induced by thrombin and collagen. RvD2 pretreatment significantly decreased the spreading area of platelets on immobilized fibrinogen and delayed clot retraction. Furthermore, the putative GPR18 antagonist O-1918 successfully abolished the RvD2-mediated inhibition of aggregation and clot retraction. Using wild-type (WT) and Gpr18 knockout (Gpr18-/-) mice, we confirmed that RvD2 exerted its inhibitory effects on aggregation and ATP release only in WT mice. In a FeCl3-induced mesenteric artery thrombosis model, intravenous administration of RvD2 (0.5 μg/kg) significantly prolonged the time to first microthrombus formation (>20 μm) and the final vessel occlusion time in WT mice, whereas this antithrombotic protection was entirely lost in Gpr18-/- mice. Finally, clinical cohort analysis of 77 patients with coronary heart disease (CHD) revealed that baseline plasma RvD2 levels were negatively correlated with ADP- and collagen-induced platelet reactivity. Our findings demonstrate that RvD2 attenuates platelet activation and thrombosis via the GPR18 receptor, and that the platelet hyperreactivity observed in patients with CHD may be associated with reduced plasma RvD2 levels.

ObjectiveRadiofrequency catheter ablation (RFCA) has become a first-line treatment for atrial fibrillation (AF). Abnormal force-over-time (FOT), a procedural parameter, leads to gaps and influences ablation continuity and transmurality. Intracardiac echocardiography (ICE) provides valuable guidance during RFCA. This retrospective study investigates the impact of ICE on FOT and recurrence in RFCA.MethodsPropensity score matching (PSM) was performed to mitigate the impact of intergroup imbalance. The Kendall correlation, point-biserial correlation coefficient test and multivariate Gamma regression were employed to analyze factors influencing procedure and ablation time. Univariate and multivariate Cox regression analysis were performed to analyze factors influencing recurrence.ResultsA total of 167 patients were enrolled. After PSM, 102 patients were included with 51 patients in each of the ICE and non-ICE groups. After adjusting for confounding factors, baseline eGFR (HR = 0.97, 95% CI 0.94–0.99, P = 0.017) and high FOT count in RPS segment (HR = 1.48, 95% CI 1.05–2.09, P = 0.025) were independent factors influencing recurrence. The eGFR (RR = 1.005, 95% CI 1.000–1.009, P = 0.038) and low FOT count in LAI segment (RR = 1.019, 95% CI 1.002–1.036, P = 0.033), high FOT count in RPI segment (RR = 0.948, 95% CI 0.902–0.996, P = 0.036) were factors influencing ablation time, while high FOT count in LF segment (RR = 1.072, 95% CI 1.008–1.139, P = 0.029), cardiomyopathy (RR = 2.181, 95% CI 1.339–3.554, P = 0.002), and LAAO (RR = 1.485, 95% CI 1.249–1.766, P < 0.001) were factors influencing procedure time.ConclusionsICE influences the distribution of abnormal FOT across PV segments. ICE-guided procedures demonstrated improvement in recurrence. However, the benefits may not be directly provided by ICE but rather mediated through the occurrence of abnormal FOT.

This paper aims to clarify the mechanism of action of Cardiac Contractility Modulation in heart failure treatment, synthesize key clinical evidence supporting the combination of Cardiac Contractility Modulation and implantable cardioverter-defibrillators for managing heart failure with reduced ejection fraction, and explore potential challenges and future applications pertaining to this combined therapy. Recent studies indicate that cardiac contractility modulation therapy improves ventricular function without elevating myocardial oxygen consumption, promotes recovery of diastolic and systolic function, augments myocardial contractility, and exhibits substantial efficacy in drug-refractory chronic heart failure. Additionally, cardiac contractility modulation markedly improves left ventricular function, reduces hospitalization frequency, and enhances quality of life in patients with heart failure with reduced ejection fraction and a QRS duration of 120–149 ms. It may also serve as a pivotal strategy to arrest progression of heart failure with preserved ejection fraction. Combining implantable cardioverter-defibrillators with cardiac contractility modulation addresses a critical gap in the clinical management of patients with heart failure with reduced ejection fraction. These individuals meet criteria for left ventricular assist devices but are ineligible for cardiac resynchronization therapy and fail to derive long-term survival benefits from implantable cardioverter-defibrillator monotherapy. This review demonstrates that combining cardiac contractility modulation and implantable cardioverter-defibrillators shows potential for improving outcomes in specific populations with heart failure with reduced ejection fraction by addressing limitations of single-therapy approaches. A key implication is that this combined strategy may offer a valuable therapeutic option for patients underserved by current guidelines. However, further rigorous clinical investigations are needed to fully establish its long-term efficacy, safety, and optimal patient selection criteria. These findings highlight the need for future research to refine the application of this combined therapy and expand its evidence base, which may inform future treatment guidelines for heart failure with reduced ejection fraction. (Created in BioRender. Marina, T. (2025) https://BioRender.com/l82n523 )

BACKGROUND:This study was to investigate the risk factors for recurrence after radiofrequency ablation (RFCA) in patients with persistent atrial fibrillation (PeAF) and analyse its correlation with plasma microribonucleic acid (miRNA) expression based on ultrasound cardiograms. METHODS:A total of 126 PeAF patients who underwent RFCA were selected as the research subjects (AF group), and 126 healthy subjects matched by gender and age were included as the control (control group). The basic data and biochemical indexes of the included research subjects were collected, and the subjects were followed up for one year after surgery. According to AF recurrence, all research subjects were divided into the recurrence group (45 cases) and the unpredictable group (81 cases). The t-test or Mann-Whitney U Test was adopted to compare B-type natriuretic peptide (BNP), uric acid (UA), glycosylated hemoglobin (HbA1c), and other biochemical indicators among patients in recurrence group and unpredictable group. In addition, left atrial diameter (LAD), left atrial volume (LAV), and left atrial ejection fraction (LAEF) were measured in both groups of patients. Logistic regression analysis was performed to identify the primary risk factors for recurrence among patients with PeAF after RFCA. Furthermore, the receiver operating characteristic (ROC) curve was used to compare the area under the curve (AUC) of the identified risk factors. RESULTS:AF duration in the recurrence group was shorter than that in the unpredictable group (P<0.01). The proportion of patients with a CHADS2 score of two or above in the recurrence group was significantly higher than that in the unpredictable group (P<0.05) in addition to UA (P<0.05) and BNP (P<0.001). Similarly, the LAD and LAV in the recurrence group were significantly higher (P<0.01), and LAEF was also found to be superior (P<0.05) in comparison to the unpredictable group. The relative expressions of plasma miRNA-150 and miRNA-133 of the patients in the AF group were remarkably reduced compared with those in the control group (P<0.05), while the relative expressions of miRNA-206, miRNA-21, miRNA-31, miRNA-27b, and miRNA-328 were all significantly increased (P<0.05) in contrast to those in the control group, and the plasma miRNA-21 (P<0.001) and miRNA-27b (P<0.05) expression of the patients in the recurrence group were significantly higher than that in the unpredictable group. AF duration (odds ratio (OR) = 1.182, 95% confidence interval (CI): 1.021~1.357), LAD (OR=2.066, 95% CI: 1.203~4.491), miRNA-21 (OR=1.253, 95% CI: 1.012-1.647), and miRNA-27b (OR=1.186, 95% CI: 1.006-1.391) were all correlated with recurrence among patients with PeAF after RFCA (P<0.05). The AUCs of AF duration, LAD, miRNA-21, and miRNA-27b LAD were found to be 0.654, 0.703, 0.795, and 0.815, respectively. The sensitivity values were 0.687, 0.701, 0.734, and 0.789, while the corresponding specificity values were 0.754, 0.732, 0.825, and 0.866, respectively. After AF duration, LAD and the expressions of miRNA-21 and miRNA-27b were combined as composite indexes, which resulted in an increased AUC (0.879), where the comparison with the AUC of a single index was significantly different (P<0.05). CONCLUSIONS:AF duration, LAD, and the expressions of plasma miRNA-21 and miRNA-27b were the independent risk factors for recurrence among PeAF patients after RFCA.

Background and objectiveThe complement system plays a crucial role in the pathogenesis and progression of cardiovascular diseases. C1q, a key initiator of the classical pathway, is closely associated with various chronic inflammatory conditions. This observational study aims to elucidate the potential risk relationship between serum complement C1q levels and atrial fibrillation (AF).Materials and methodsThis retrospective cohort study included 812 AF patients treated at the Affiliated Hospital of Qingdao University from January 2020 to October 2022, comprising 694 patients in the paroxysmal AF group and 118 in the persistent AF group. Serum complement C1q levels were measured using an enzyme-linked immunosorbent assay (ELISA).ResultsSerum C1q levels in the AF group were significantly lower than those in the control group (P < 0.001). Logistic regression analysis indicated that reduced plasma C1q levels were independently associated with the incidence of AF (95% CI = 0.974–0.981, P = 0.001). Additionally, ROC curve analysis confirmed the close association between plasma C1q levels and AF, highlighting the predictive value of C1q for AF. Further investigation revealed that C1q serves as an independent risk factor for complex fractionated atrial electrograms (CFAE) in the superior left atrium of paroxysmal AF patients (95% CI = 0.984–0.998, P = 0.031), suggesting its potential as a clinical indicator for guiding AF surgical interventions.ConclusionSerum C1q levels are significantly reduced in patients with AF. The presence of CFAE in the superior left atrium of paroxysmal AF patients may be potentially associated with C1q levels. Low complement levels are associated with atrial fibrillation compared to individuals without AF and may represent a potential underlying cause of impaired sinus rhythm maintenance following pulmonary vein isolation. Complement C1q may play a critical role in the pathogenesis of AF.

ABSTRACTAimTo cross‐culturally adapt the Knowledge about Atrial Fibrillation and Stroke Prevention Questionnaire (KAFSP‐Q) for Chinese AF patients and validate its effectiveness.DesignInstrument adaptation and cross‐sectional validation.MethodsThe KAFSP‐Q was translated into Chinese by using the forward and back translation method. Experts and patients were invited to revise the questionnaire domains and items. The psychometric properties of the Chinese version of the KAFSP‐Q were evaluated, that is, its construct validity, discriminant validity, convergent validity, internal consistency and test–retest reliability.FindingsThe Chinese version of the KAFSP‐Q consists of 41 items and six domains, namely, bleeding knowledge, AF complications, stroke risk and stroke prevention, stroke symptoms, AF symptoms and general AF knowledge. The Chinese version of the KAFSP‐Q demonstrated acceptable content validity (scale‐content validity index = 0.859). The exploratory factor analysis revealed six factors, which accounted for 65.725% of the total variance, and the confirmatory factor analysis revealed acceptable fit indices. The convergent validity was poor, because the average variance extracted coefficient of the six domains was lower than 0.500. The square root of the average variance extracted coefficients was higher than the bivariate correlation between the domains, which indicated an acceptable discriminant validity. Meanwhile, the internal consistency and test–retest reliability were satisfactory (Cronbach's α coefficient = 0.973, intraclass correlation coefficient = 0.872).ConclusionsThe Chinese version of the KAFSP‐Q demonstrates acceptable validity and reliability and can be used as a valuable instrument for AF and stroke prevention knowledge evaluation.ImpactIn clinical practice, the Chinese version of the KAFSP‐Q can be used to help patients increase their disease management knowledge and engage in effective disease management behaviour. Future research is necessary to confirm the psychometric properties of the questionnaire with samples that are highly representative.Patient or Public ContributionNo patient or public contribution.

Objectives To compare the hemorrhage complications between the coadministration of dronedarone and rivaroxaban and that of amiodarone and rivaroxaban after radiofrequency ablation in patients with atrial fibrillation (AF). Methods Fifty patients with AF and abnormal thyroid function were administered dronedarone and rivaroxaban (Group D-R) after catheter ablation, and fifty patients with AF and normal thyroid function received dronedarone and rivaroxaban (Group A-R) after the operation were matched using propensity score matching. All patients returned for follow-up once a month for 3 months. The incidence of minor hemorrhage, massive hemorrhage, thromboembolism, and the recurrence rate of atrial fibrillation were observed. Results No significant difference was noted in the incidence of postoperative minor bleeding between the Group D-R and the Group A-R（2% versus 4%, P=0.558）, and no massive hemorrhage and ischemic events were detected in both groups. Also, no significant difference was observed in recurrence rate of AF between two groups(18% versus 16%, P=0.790). Conclusions Compared to the coadministration of amiodarone and rivaroxaban, that of dronedarone and rivaroxaban does not increase the risk of hemorrhage, thromboembolism and AF recurrence after radiofrequency ablation.

Atrial fibrillation is the most common arrhythmia in adults. The interplay between epicardial adipose tissue and atrial fibrillation has garnered significant scientific interest. Recently, the combined approach of radiofrequency ablation and left atrial appendage occlusion has become a widely adopted strategy for managing non-valvular atrial fibrillation patients at high risk of thrombus formation. This study aims to assess the prognostic significance of epicardial adipose tissue volume in patients undergoing radiofrequency ablation in conjunction with left atrial appendage occlusion. This study results indicate that in patients undergoing the one-stop procedure, which comprises catheter radiofrequency ablation and percutaneous left atrial appendage occlusion, epicardial adipose tissue volume is significantly associated with AF recurrence post-strategy. Higher EATV predicts AF recurrence (HR = 1.17, 95%CI1.047-1.192, P = 0.001) and thromboembolism (P = 0.002) following the one-stop procedure. Epicardial adipose tissue volume serves as a significant predictor of atrial fibrillation recurrence following the one-stop procedure (area under the curve 0.648, 95%CI0.571-0.725, P = 0.002, sensitivity 0.88, specificity 0.50).

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BackgroundPatients with non-valvular atrial fibrillation (NVAF) and previous stroke have a significantly higher risk of stroke recurrence. This study aimed to examine the safety and efficacy of the LAmbre left atrial appendage occlusion device in NVAF patients with a history of stroke.MethodsWe examined 103 consecutive NVAF patients in 11 Chinese medical centers who had a history of stroke or transient ischemic attacks (TIA) and underwent placement of the LAmbre device. Follow-up was conducted 1, 3, 6, and 12 months after the procedure. The primary endpoints were the incidence of new ischemic or hemorrhagic stroke, TIA, systemic embolism, or cardiac death. Secondary endpoints were serious perioperative or device-related complications and cerebral, gastrointestinal, or other bleeding events requiring transfusion of at least 2 units of packed red blood cells.ResultsMean patient age was 67.63 +/- 7.14 years; mean CHA2DS2-VASc score was 4.72 +/- 1.18 and mean HAS-BLED score was 1.90 +/- 1.00. LAmbre device placement was successful in 101 patients (98.05%). Mean follow-up was 12.2 months. Five patients (4.95%) developed a new pericardial effusion after the procedure; none required treatment. Eighty-six patients (85.15%) exhibited no peri-device leak (PDL). However, 13 (12.8%) had a small (0-3 mm) PDL and two (2.3%) had a moderate PDL (3-5 mm). One recurrent stroke occurred during follow-up (1.1%). No other complications occurred.ConclusionsThis multicenter study shows the safety and efficacy of LAmbre left atrial appendage occlusion for NVAF patients with a history of stroke or TIA.

经皮左心耳封堵术是预防心房颤动(房颤)血栓栓塞事件的有效方法,多用于具有抗凝禁忌或规范抗凝过程中仍出现血栓栓塞事件的非瓣膜性房颤患者,但不同房颤患者左心耳解剖结构具有差异,单一封堵器无法完全封闭左心耳,本文旨在报道双叶左心耳房颤患者成功植入两个左心耳封堵装置1例.

Background: The influencing factors of kinesiophobia (fear of movement) in patients with atrial fibrillation(AF) during the post-operative "Blanking Period " are not known. The aims were to investigate the status of kinesi-ophobia in patients with AF during the post-operative "Blanking Period ", then further describe the occurrence and analyze the influencing factors of patients' kinesiophobia by the Fear-Avoidance Model. Materials and methods: In total,400 patients diagnosed with atrial fibrillation, during the post-operative "Blanking Period " from the selected hospital were included in this study. The Tampa Scale for Kinesiophobia Heart (TSK-SV Heart), the Self-efficacy for Exercise (SEE) scale, and the Geriatric Locomotive Function Scale (GLFS) were used to assess kinesiophobia, exercise self-efficacy, and physical function. The study adopted a cross-sectional design. Results: The score of kinesiophobia during the "Blanking Period " after operation in patients with atrial fibrillation was (44.06 +/- 10.77), and the rate of high kinesiophobia was 71.61%.Logistic regression results showed that age, education, household monthly income, resting heart rate, EHRA symptom classification, exercise self-efficacy, and physical function influenced the kinesiophobia of patients during the post-operative "Blanking Peri-od "(p < 0.05, p < 0.01). Conclusions: Kinesiophobia is common in patients with atrial fibrillation during the postoperative "Blanking Period ", and the fear of movement is related to age, education, household monthly income, resting heart rate, EHRA symptom classification, exercise self-efficacy, and physical function. Clinical and nursing staff should pay close attention to the psychological problems in the post-operation "Blanking Period " of exercise rehabilitation in patients with atrial fibrillation, make timely interventions to reduce patients' fear of movement, and improve patients' compliance with exercise rehabilitation.

To investigate whether co-administration of antiarrhythmic dronedarone and anticoagulant rivaroxaban would increase the risks of hemorrhage after atrial fibrillation (AF) ablation. A total of 100 patients with AF who underwent radiofrequency catheter ablation (CA) in the Department of Cardiology, the Affiliated Hospital of Qingdao University from 2019–12 to 2020–11 were included. Patients were divided into an oral dronedarone and rivaroxaban group (D-R group, N = 50) and an oral amiodarone and rivaroxaban group (A-R group, N = 50) according to the postoperative antiarrhythmic and anticoagulation strategies. Patients in 2 groups were given propensity score matching (PSM) to obtain a sample with balanced inter-group covariates. A retrospective observational study was conducted. After 3 months of follow-up, the incidence of clinically relevant non-major bleeding (CRNMB), major hemorrhages, and early AF recurrence was observed. After PSM, 41 patients were included in each group. With similarly distributed baseline characteristics and ablation characteristics after PSM, the CRNMB rate after AF ablation was significantly higher in the D-R group than in the A-R group (26.8% versus 7.3%, P = 0.02), and no major hemorrhages were detected in both groups. No significant difference was observed in the sinus rhythm maintenance rate between the D-R group and the A-R group (26.8% vs. 22.0%, P = 0.43). Compared to co-administration of amiodarone and rivaroxaban, co-administration of dronedarone and rivaroxaban increases the risk of CRNMB but it does not increase the risk of major hemorrhages in blanking period after AF ablation.

目的 探究射频消融联合左心耳封堵一站式治疗心房颤动的效果,并比较一站式术后空窗期内服用华法林、利伐沙班、达比加群酯抗栓的有效性与安全性.方法 纳入2019年6月—2020年10月就诊于我院并行射频消融联合左心耳封堵一站式手术的心房颤动患者150例,随机分为3组,分别在术后空窗期(3个月)内服用华法林、利伐沙班、达比加群酯进行抗栓治疗,观察3组患者在空窗期内出血性事件、缺血性事件及器械相关血栓形成的发生率,并比较左心耳封堵的效果.结果 围手术期,3组患者心包积液或局部出血的发生率比较差异无显著性(P>0.05),且均未发生围手术期死亡、卒中/短暂性脑缺血发作(TIA)、系统性栓塞、器械栓塞及大出血事件.在(13.33±3.20)个月的随访中,3组患者均未发生死亡、卒中/TIA、系统性栓塞、器械相关血栓形成;3组患者之间系统性出血或局部出血发生率比较差异无显著性(P>0.05).术后3个月随访时,3组患者封堵器周围残余分流例数及残余分流大小比较差异无显著性(P>0.05).结论 射频消融联合左心耳封堵一站式治疗心房颤动安全有效,术后空窗期内服用华法林、利伐沙班或达比加群酯也均安全、有效.

AIM:To explore whether sense of mastery can mediate the relationship between social support and illness perception in patients with atrial fibrillation (AF) who were at the "Blanking Period." DESIGN:A cross-sectional design. METHODS:405 patients with AF who were at the "Blanking Period" in the Affiliated Hospital of Qingdao University were recruited; they completed a set of questionnaires, including the Perceived Social Support Scale, the Personal Mastery Scale and the Brief Illness Perception Questionnaire. RESULTS:Social support and sense of mastery were both adversely connected to illness perception. The indirect effect of social support on illness perception through sense of mastery was negative, accounting for 86.04% of the total effect. CONCLUSION:During the "Blanking Period," better social support and sense of mastery contribute to a positive illness perception of AF patients. Social support also can influence patients' illness perception indirectly via the mediator of sense of mastery.

For heart failure(HF) patients with reduced ejection fraction and atrial fibrillation (AF) with rapid ventricular response, cardiac resynchronization therapy (CRT) combined with atrioventricular junction ablation (AVJA) is an important treatment strategy. This article reports a case of HF with AF with rapid ventricular response in which the left ventricular lead implantation of CRT failed, and was successfully treated with left bundle branch pacing(LBBP) combined with AVJA and related literature is reviewed.

Objective:To form an evidence-based practice standard for early ambulation after radiofrequency catheter ablation via femoral artery (RFCA) , so as to improve the awareness of nurses' evidence and the rate of clinical practice standards, and reduce the incidence of patient complications.Methods:Totals of 2 evidence summaries, 4 systematic reviews and 2 guidelines were included through searching domestic and foreign databases. The innovation-Promoting Action on Research Implementation in Health Services (i-PARIHS) was used to analyze the obstacles to the application of evidence and formulate available solutions. From June 2019 to November 2020, convenience sampling was used to select 180 patients who underwent RFCA and 39 nurses in the Department of Cardiovascular of the Affiliated Hospital of Qingdao University for evidence-based.Results:A standardized procedure and evaluation record form for the guidance of ambulation after RFCA were formed, and the nursing norms after RFCA were updated. After 2 rounds of evidence application, the awareness and implementation rates of the nurses' review indicators increased, and the differences were statistically significant ( P<0.01) . After 2 rounds of evidence application, the patients' low back pain score and anxiety score were lower than those before the evidence application, and the differences were statistically significant ( P<0.01) . The incidence of dysuria and the vagus nerve firing in patients were lower than those before the evidence application, and the differences were statistically significant ( P<0.05) . Conclusions:The development of this evidence-based project promotes early postoperative ambulation of patients and reduces the incidence of complications.

目的 调查房颤患者射频消融术后"空白期"生活掌控感现状并分析其影响因素,为患者制订康复方案提供参考.方法 采用一般资料调查表、个人生活掌控感量表、简化版疾病感知问卷、领悟社会支持量表对204例射频消融术后"空白期"房颤患者进行问卷调查.结果 房颤患者射频消融术后"空白期"生活掌控感总得分20.75±5.86;疾病感知总得分52.50±12.42;社会支持总得分65.58±9.90.多元逐步回归分析结果显示,文化程度、家庭收入、房颤病程、并存疾病数、疾病感知、社会支持是患者术后"空白期"生活掌控感的影响因素(P＜0.05,P＜0.01).结论 房颤患者射频消融术后"空白期"生活掌控感水平较低,医护人员应多关注低文化程度、低经济收入、短病程、有合并症的患者;通过个性化健康教育引导患者减轻负性情绪,改善负向疾病感知,促进患者生活掌控感水平提升和生活质量改善.

Objective:To compare the electromechanical synchrony and clinical prognosis between left bundle branch pacing (LBBP) and right ventricular septal pacing (RVSP) , and evaluate the feasibility and safety of LBBP in patients with third degree atrioventricular block.Methods:A total of 100 patients with third degree atrioventricular block requiring permanent pacing treatment from January 2019 to March 2020 in department of cardiology of The Affiliated Hospital of Qingdao University were randomly divided into 2 groups with Random Number Table, and then operating LBBP and RVSP respectively. The left ventricular 12 segment Ts standard deviation (Tsd-12-LV) , pacing parameters, QRS duration (QRSd) , QTc interval, left ventricular ejection fraction (LVEF) , left ventricular end diastolic diameter (LVEDD) , left ventricular lateral wall basal segment and right ventricular free wall basal systolic velocity peak time (Ts) (Ts-LV-RV) , and left ventricular filling time and RR interval ratio (LVFT/RR) were followed up and compared between the two groups.Results:Fifty cases of LBBP and 50 cases of RVSP were successfully performed. Pacing threshold, perception and impedance changes were stable after operation, and there was no significant difference between the two groups. six months after procedure, the QRSd[ (110.00±10.96) ms vs. (120.22±22.61) ms], Ts-LV-RV[ (33.88±5.50) ms vs. (38.68±10.33) ms] and LVFT/RR[ (42.38%±3.57%) vs. (54.54%±5.62%) ]in LBBP group were improved, compared with the preoperation ( P<0.05) . The LVEF, LVEDD, Tsd-12-LV and QTc intervals were not significantly different with those before operation ( P>0.05) . The LVEDD, LVEF, Ts-LV-RV and QTc intervals in the RVSP group were not significantly different from those before operation ( P>0.05) , while the LVFT/RR was improved 6 months after operation ( P<0.01) . The QRSd and the Tsd-12-LV of the RVSP group were increased compared with those before operation. No recurrence of heart failure, tachyarrhythmia hospitalization or death and other related events. Conclusion:The pacing parameters of left bundle branch pacing during half-year follow-up were stable. In the aspect of improving electromechanical synchronization, LBBP is better than right ventricular septal pacing.

Abstract Objective To identify the risk factors for postoperative atrial fibrillation (AF) recurrence in nonvalvular AF patients undergoing radiofrequency catheter ablation (CA). Methods We retrospectively reviewed the data from 426 of 450 AF patients who underwent CA. Patients were divided into two groups according to recurrence after the operation; the risk factors for AF recurrence were analyzed. A stratification system for lesions was created based on the cutoff of the risk factors; the associations among the subgroups and the AF recurrence rate were analyzed. Results AF recurrence occurred in 98 (23.0%) patients. Univariate analysis demonstrated that AF type, hypertrophic cardiomyopathy, left atrial diameter (LAD), left ventricular ejection fraction (LVEF), serum albumin, and D‐dimer concentrations were associated with AF recurrence. AF type (OR =2.907, p < .001), serum albumin concentration (OR =1.112, p < .05), and LAD (OR =1.115, p < .001) were independent risk factors for AF recurrence. The area under the ROC curve of LAD for the prediction of AF recurrence was 0.722 (95% CI: 0.664~0.779) and that of serum albumin for the prediction of AF recurrence was 0.608 (95% CI: 0.545~0.672). Further stratification revealed that patients with persistent or paroxysmal AF with LAD ≥43.5 mm and serum albumin concentration ≥42.2 g/L had a higher rate of AF recurrence than the reference group. Conclusion Atrial fibrillation type, LAD, and serum albumin concentration are risk factors for AF recurrence after CA in patients with nonvalvular AF. Patients with persistent AF with LAD ≥43.5 mm and serum albumin concentration ≥42.2 g/L have a higher risk of late AF recurrence after surgery.