Abstract:Objective To explore the related factors of arrhythmia recurrence in patients with refractory atrial fibrillation (AF) treated by minimally invasive pulmonary vein isolation combined with radiofrequency ablation under endocardial mapping. Methods A total of 102 refractory AF patients, who received pulmonary vein minimally invasive isolation combined with radiofrequency ablation under endocardial mapping from March 2014 to December 2016, were selected and were followed up for 12 months.The clinical data and the recurrence of arrhythmia were recorded to investigate the related factors for arrhythmia recurrence. Results Univariate Cox regression analysis showed that age more than 65 years old, left atrial volume (> 165 ml), non-sinus rhythm after surgical treatment, inducible atrial fibrillation with self-termination were the risk factors affecting the arrhythmia recurrence of patients (P<0.05), and non-inducible atrial fibrillation was the protective factor for arrhythmia recurrence of patients (P<0.05).Multivariate Cox regression analysis showed that left atrial volume more than 165 ml, non-sinus rhythm after surgery, and inducible atrial fibrillation with self-terminating or persistence (more than 30 s) are the risk factors for the arrhythmia recurrence of patients (P<0.05). Conclusion Minimally invasive pulmonary vein isolation combined with radiofrequency ablation can effectively treat refractory atrial fibrillation.Non-sinus rhythm and inducible atrial fibrillation with atrial volume > 165 ml after surgical treatment are the risk factors for arrhythmia recurrence.