速度向量成像技术评价心房颤动患者射频消融术后急性期左心房功能

Evaluation of left atrial function immediately after radiofrequency catheter ablation for atrial fibrillation by velocity vector imaging

目的运用超声心动图速度向量成像（velocityvectorimaging，VVI）技术评价射频消融术后急性期对阵发性及持续性心房颤动患者左房功能的影响。方法分别采集10例阵发性心房颤动患者术前术后、10例持续性心房颤动患者术后及对照组10例左房的容积及各壁的速度、应变及应变率，分别对比阵发性心房颤动患者术前术后、持续性心房颤动患者术后与对照组的左房功能。结果射频消融术后急性期对阵发性心房颤动患者左房功能无损害，术后经体表标化的左房面积较对照组明显增大；持续性心房颤动患者左房的整体功能左房排空分数（LAEF）、左房的主动排空分数（LAaEF）及左房的扩展指数较对照组降低，左房房间隔及侧壁的收缩期应变减低，房间隔的收缩速度较对照组减低，差异有统计学意义（均P〈0．05）。结论VVI显示射频消融术急性期对阵发性心房颤动患者左房功能无损害，持续性心房颤动患者左房功能减低。

Objective To evaluate the immediate impact of radiofrequencycatheter ablation on left atrial （LA） volumes and function by velocity vector imagJng（VVI） and compare the LA function with and without atrial fibrillation after the operation. Methods Ten consecutive patients with paroxysmal AF were studied at baseline and within 3 days after ablation. Ten consecutive patients with persistent AF were studied within 3 clays after ablation,in sinus rhythm. Ten patients with normal ventricular function were included in the study. VVI was performed to assess LA sizes and strain, strain rate, velocity of the septum, lateral wall and the atrial roof from the apical four-chamber view. Results In patients with paroxysmal AF, global and regioal LA function was not significantly impaired after the ablation procedure. Subgroup analysis demonstrated that there were no significant difference in LA function betwwen patients with paroxysmal AF and control subjects, but the indexed LAVmax was significantly larger in all AF patients compared with control subjects. The global function of LA, including LAEF,LAaEF and LA expansion index significantly decreased in persistent AF patients. By contrast, the LA septal strain,velocity and lateral strain were lower than controls. Conclusions Radiofrequency catheter ablation has no influence on LA function assessed by VVI within three days after the operation for patients with paroxysmal AF. The function of persistent AF patients is absolutely lower than control subjects.