实时三维超声心动图评价不同房颤消融术式对左心房功能的影响

Real-time Three-dimensional Echocardiography for Evaluating the Left Atrial Function Following Different Radiofrequency Ablations

目的通过实时三维超声心动图(RT3DE)评价节段性肺静脉隔离术(SPVI)和左心房线性消融术(CPVA)对阵发性房颤(PAF)患者左心房容积及功能的影响。资料与方法接受SPVI和CPVA的69例PAF患者术后随访6个月,分为SPVI组(26例)和CPVA组(43例)。比较两组患者RT3DE左心房容积参数,包括左心房内径(LA)、左心房最大容积(LAVmax)、左心房最小容积(LAVmin)以及左心房功能参数,包括左心房射血分数(LAEF)、左心房搏出量(LASV)、左心房功能指数(LAFI)。结果术后6个月,SPVI组和CPVA组中消融成功者LAVmax为(70.27±9.32)ml、(69.79±6.12)ml,LAVmin为(62.39±7.18)ml、(59.48±6.12)ml,均较术前减小(P<0.05);LAFI为0.36±0.19、0.38±0.73,LAEF为(60.34±1.55)%(、60.32±1.73)%,均较术前增加(P<0.05);SPVI组LAVmax、LAVmin、LAFI、LAEF与CPVA组比较,差异均无统计学意义(P>0.05)。结论 RT3DE显示消融成功的PAF患者左心房结构和收缩功能好转,但采用SPVI术及CPVA术对左心房容积及功能的影响并无差异。

Purpose To evaluate the left atrial volume and function using real-time three- dimensional echocardiography （RT3DE） in patients undergoing segmental pulmonary vein isolation （SPVI） and circumferential pulmonary vein ablation （CPVA） tbr paroxysmal atrial fibrillation （PAF）. Materials and Methods Sixty-nine patients with PAF patients undergoing SPVI （n=26） or CPVA （n=43） were followed up lbr 6 months. Lelt atrial volume and functional parameters on RT3DE were compared, including the internal dial-neter （LA）, the maximum volume （LAV,,,,x）, the minimal volume （LAV,,~,,）, the left atrial ejection fi＇action （LAEF）, the left atrial stroke volume （LASV）, and the left atrial t＇unction index （LAFI）. Results Six months after ablation, patients achieved successthl ablation in SPVI group and CPVA group showed LAVm：~, of （70.27 4- 9.32） ml and （69.79 4- 6.12） rnl, respectively; LAVmin of （62.394- 7.18） mI and （59.48 4- 6.12） ml, respectively, which were statistically decreased than those before ablation （P〈O.05）. In the above two groups, LAFI of 0.36 4-0.19 and 0.384-0.73, respectively; LAEF of （60.344- 1,55）% and （60.32_＋1.73）%, respectively, which were significantly increased than those befbre ablation （P〈0.05）. There was no statistical difference in LAV LAV, LAFI or LAEF between SPVI group and CPVA group （P〉0.05）. Conclusion RT3DE can demonstrate the improvement in structure and function of left atrium following ablation, however, there is no difference between these two techniques.