慢性心房颤动患者射频消融术后左心房和左心室远期结构变化

Long-tem structure changes of left atrial and left ventricular chamber after radiofrequency ablation for patients with chronic atrial fibrillation

目的探讨慢性心房颤动患者射频消融术后左心房和左心室远期结构变化。方法 2010年2月～2012年2月期间,我院实施射频消融术的80例慢性心房颤动患者,平均随访12个月,其中42例术后维持窦性心律(未复发组),另外38例术后复发(复发组),于术前、术后12个月随访时,应用超声心电图检查,测量和比较两组左心房前后径、最大容积,左心室舒张末期内径、收缩末期内径、射血分数。结果与术前相比,术后未复发组患者左心房前后径、最大容积,左心室舒张末期内径、收缩末期内径均明显减少,左室射血分数明显增加,差异有统计学意义(P<0.05);与术前相比,术后复发组左心房、左心室结构指标变化不大,差异无统计学意义(P>0.05)。结论对于射频消融术后12个月慢性心房颤动患者,窦性心律能够逆转左心房、左心室重构,增强左室收缩功能。

Objective To study the long-tern structure changes of left atrial and left ventricular chamber after radiofrequency ablation for patients with chronic atrial fibrillation. Methods In the 80 patients with chronic atrial fibrillation treated by radiofrequency ablation in our hospital during the period from Feb 2010 to Feb 2012, there were the 42 patients with sinus rhythm （non-recurrence group） and the other 38 patients with postoperative recurrence （recurrence group） with the mean 12 months follow-up. At prior to and 12 months post radiofrequency ablation, the left atrial anteroposterior diameter, the left atrial maximum volume （LAVmax）, the left ventricular end-diastolic diameter （LVEDd）, the left ventricular end-systolic diameter （LVESd） and the left ventricular ejection fraction （LVEF） in the two groups were measured and compared by the echocardiography. Results compared with the pre-operation, the left atrial anteroposterior diameter, LAVmax, LVEDd and LVESd were significantly reduced and LVEF was obviously increased in the non-recurrence group with statistical difference, P 〈 0.05. Compared with the pre-operation, the left atrial and left ventricular structure parameters were not significant changes with no statistical difference, P 〉 0.05. Conclusion For patientswith chronic atrial fibrillation at 12 months after treatment by radiofrequency ablation, the sinus rhythm can reverse the left atrial and left ventricular remodeling and improve the left ventricular systolic function.