经食管超声检测房颤射频消融前左房自发性显影和左心耳血栓

Left atrial spontaneous imaging and right auricle appendage thrombosis before the radio frequency catheter ablation by transesophageal echocardiography

目的探讨经食管超声心动图在房颤射频消融治疗前对左房自发性显影和左心耳血栓的诊断价值。方法对26例拟行射频消融的非瓣膜性房颤患者进行常规经胸超声心动图和经食管超声心动图检查,总结分析左房自发性显影和左心耳血栓检出情况。结果 26例房颤患者TTE发现左房自发性显影2例,占7.7%(2/26),未检出左心耳血栓;TEE发现左心耳自发性显影10例,占38.5%(10/26),左心耳血栓6例,占23.1%(6/26)。超声图像显示:左心耳扩大;左心耳出现异常团块回声,在心耳壁的附着面较宽大,彩色多普勒二尖瓣上少量、中量或大量反流;左房或左心耳可探及漩涡状或云雾状征象为SEC。结论经食管超声心动图明显提高了左房自发性显影和左心耳血栓的检出率,减少了房颤射频消融治疗的风险。

Objective To explore the diagnostic value of transesophageal echocardiography in the left atrial spontaneous imaging and left atrial appendage thrombus before atrial fibrillation radiofrequency ablation treatment.Methods 26 cases of patients with non-valvular atrial fibrillation received check of ultrasonic cardiogram and transesophageal echocardiography before radiofrequency ablation treatment,the situation of Left atrial spontaneous imaging and left artrial appendage throm bus were summarized.Results Left atrial spontaneous imaging were found in 2 of 26 patients（7.7%） via check of ultrasonic cardiogram,left artrial appendage thrombus were not found in the two patients.Left atrial spontaneous imaging;were found in 10 of 26 patients（38.5%） via check of transesophageal echocardiography.Left artrial appendage thrombus were found in 6 of 26 patients（23.1%）.Ultrasonic image showed left atrial appendage expanded,abnormal clumps echo appeared in left atrial ap pendage,most were attached to the atrial appendage wall.Mitral regurgitation was found via color Doppler ultrasonography.Swirling or cloudy signs which were explored in left atrial appendage were spontaneous ultrasonic imaging.Conclusion Check of transesophageal echocardiography increases the detection rate of left atrial spontaneous imaging;and left artrial appendage thrombus,decreases the risk of atrial fibrillation radiofrequency ablation treatment.