AIM To Explore the postoperative recurrence rate and influencing factors of radiofrequency catheter ablation (RFCA) in the treatment of atrioventricular reentrant tachycardia (AVRT), and construct a predictive model.

METHODS A retrospective analysis was conducted on the clinical data of 554 AVRT patients who underwent RFCA treatment at the Cardiovascular Department of Chifeng College Affiliated Hospital from January 2019 to October 2022. According to the regular follow-up after surgery for AVRT recurrence, there were 46 (8%) cases in the recurrence group and 508 (92%) cases in the non recurrence group. Compare preoperative basic information, intraoperative conditions, and postoperative recurrence through univariate analysis, and explore the correlation between clinical data of the two groups of patients and postoperative recurrence of RFCA in AVRT patients; Evaluate the independent influencing factors of RFCA postoperative recurrence in AVRT patients through univariate and multivariate logistic regression analysis; Based on the results of the above multiple factor analysis, a regression equation and parameter combination were constructed, and a receiver operating characteristic curve (ROC) was plotted to calculate the sensitivity and specificity of parameter combination in predicting postoperative recurrence in AVRT patients; Evaluate the diagnostic value of individual parameters for postoperative recurrence of RFCA in AVRT patients by drawing a column chart.

RESULTS In AVRT patients receiving RFCA treatment, the recurrence rate of postoperative AVRT was 8% with a follow-up time of more than 3 months. Compared with the non recurrent group, the recurrent group had a history of myocarditis (P<0.05), accessory pathway location (decrease in left value, increase in right and bilateral values, P<0.05), number of accessory pathways (P<0.01), intraoperative induced tachycardia (P<0.05), prolonged ablation response time (P<0.05), and radiofrequency ablation consolidation time (P<0.05), All were related to postoperative recurrence of RFCA in the study subjects, and the differences were statistically significant. The results of multivariate regression analysis showed that a history of myocarditis, a complex number of right and bilateral accessory pathways, and the number of accessory pathways were independent risk factors for postoperative recurrence in AVRT patients undergoing RFCA treatment, while intraoperative induction of tachycardia was a protective factor for postoperative recurrence in AVRT patients undergoing RFCA treatment (P<0.05). Based on the results of multiple factor analysis, a predictive model was constructed as Logit (P) = 1.746 × history of myocarditis + 0.741 × location of accessory pathways + 1.176 × number of accessory pathways −0.727 × surgical center tachycardia −3.386. The sensitivity and specificity of ROC curve evaluation parameters combined with predicting postoperative recurrence in AVRT patients undergoing RFCA treatment were 84.7% and 54.9%, respectively. The area under the curve was 0.746 (95% CI: 0.684～0.807). The likelihood ratio test and discrimination evaluation C-index of the column chart model constructed based on the above clinical parameters were 32.647 and 0.743, respectively, indicating that the column chart model has good predictive ability.

CONCLUSION  A history of myocarditis and a complex number of right and bilateral accessory pathways are independent risk factors for postoperative recurrence of RFCA in AVRT patients, while intraoperative induction of tachycardia is a protective factor. The column chart constructed based on the above clinical parameters shows good predictive value for early identification of high-risk populations.