射频消融术对阵发性房颤患者左房结构和收缩功能的影响

Effects of radiofrequency catheter ablation for paroxysmal atrial fibrillation on left atrial structure and function

目的应用超声心动图观察阵发性心房颤动(PAF)患者射频前后左房结构和收缩功能的变化。方法 52例PAF患者行射频消融术,分别于术前及术后1 d、6个月时应用超声心动图测定左房内径(LAD)、左房面积(LAA)和左房容积(LAV),记录二尖瓣血流频谱A峰流速(VA)、左房射血力(LAF),同时使用组织多普勒记录二尖瓣前瓣环舒张晚期峰值速度(Va)。另选30例性别、年龄、体重匹配的窦性心律者为对照组。结果 (1)PAF患者反应左房结构的指标LAD、LAA、LAV较对照组扩大(P<0.05),反应左房收缩功能的指标较VA、LAEF、Va较对照组减低(P<0.05);(2)术后维持窦性心律者(n=45),6个月时左房结构指标较术前均显著改善(P<0.05);(3)维持窦律者术后1 d与术前比较,反应左房收缩功能的指标均减少(P<0.05),术后6个月左房功能恢复到术前水平,差异无统计学意义(P>0.05)。结论阵发性房颤患者射频成功后左房结构重构明显改善,早期左房收缩功能下降,随时间推移左房功能明显恢复。

Objective To evaluate the impact of radiofrequency catheter ablation（RFCA） on left atrial（LA） structure and function in patients with paroxysmal atrial fibrillation（PAF） with the transthoraracic echocardiography. Methods Thansthoracic echocardiography was performed on baseline,and 1 day and 6 months after treatment on 52 patients with radiofrequency ablation treatment for PAF.LA dimension（LAD）,LA area（LAA）,LA volume（LAV）,peak velocity of mitral valve inflow（VA）,LA ejection force（LAEF） and peak atrial systolic mitral annulus velocity（Va） were recorded.Volunteers with sinus rhythm of matched age,gender and weight（n=30） were enrolled as controls. Results Significant increase of LA structural indicators,including LAD,LAA and LAV,was observed in PAF group,comparing with those of control group（P0.05）;so was the significant reduction of left atrial systolic function indicators,including VA,LAEF and Va（P0.05）.Patients in PAF group,who kept sinus rhythm after treatment（n=45）,presented significant improvement of LA structure,comparing with baseline（P0.05）.Comparing with baseline,although those kept sinus rhythm after treatment suffered significant reduction of LA systolic function on 1st day according to respected indicators（P0.05）;no significant loss of LA systolic function in 6th month（P0.05）. Conclusion In patients who maintain sinus rhythm after RFCA,the remodeling and reduced systolic function of the left atrium is reversed.