阵发性心房颤动患者环肺静脉隔离术后心房同步性变化

Change of atrial synchronicity of paroxysm atrial fibrillation patients after circumferential electrical isolation of pulmonary veins

目的利用组织多普勒超声技术评价环肺静脉隔离术对阵发性心房颤动(简称房颤)患者心房同步性的变化。方法 48例阵发性房颤患者成功接受环肺静脉隔离导管消融治疗。分别于术前、术后6个月在窦性节律下行超声心动图检查,测量左房内径(LAD)、左房容积(LAV)、左房射血力(LAAEF)及二尖瓣环、三尖瓣环、室间隔房室环处电机械时间PA1、PA2、PA3,并分别计算三者之间的差值T1、T2、T3。结果肺静脉隔离术后6个月LAD较术前明显减小[(31.2±2.8)mm vs(35.1±2.1)mm,P<0.01],LAV较术前明显减小[(16.9±1.8)ml vs(18.8±1.5)ml,P<0.01],LAAEF无明显变化(P>0.05)。术后6个月T1、T2、T3与术前无差异(P>0.05)。结论术后6个月LAD、LAV较术前减小,心房同步性无明显变化。

Objective Using Doppler uhrasound to evaluate atrial synchronous changes after circumferential pulmonary vein isolation in patients with paroxysmal atrial fibrillation. Methods Forty-eight patients with paroxysmal atrial fibrillation received circumferential pulmonary vein isolation catheter ablation successfully. Respectively in the preoperative and postoperative six months, echocardiography was performed under sinus rhythm. Left atrial diameter （LAD） , left atrial volume （LAV）, left atrium the ejection force （LAAEF） were measured. The mitral annulus, tricuspid annulus, ventricular septal atrioventricular annulus electromechanieal intervals （ PA1 , PA2, PA3 ） were record and their difference of intervals were calculated separately （ T1 , T2 , T3 ）. Results Compared with the preoperative, after six months of pulmonary vein isolation, LAD, LAV were reduced [ （31.2±2.8）mm vs （35.1±2.1）mm,（16.9±1. 8） ml vs （18.8±1.5）ml,all P〈0. 01 ]. LAAEF had no change （ P〉O. 05 ） , and the index of synchronous T1 , T2 , T3 had no significant statistical difference （P〉0.05）. Conclusions Compared with preoperative , after six months, LAD, LAV reduced and atrial synchronous have no obvious change.