心房颤动患者经导管射频消融术后不同时期左心房结构及功能的动态变化
《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]
- 期数:
- 2014年第2期
- 页码:
- 187-192
- 栏目:
- 临床研究
- 出版日期:
- 2014-01-20
文章信息/Info
- Title:
- Analysis of dynamic changes in left atrial structure and function in patients with atrial fibrillation after radiofrequency catheter ablation
- Author(s):
- LI Xiao-jing; XU Jin; LIU Jian-ping; CHEN Ying-min; HE Ben; YING Xiao-ying
- (Department of Cardiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200001, China)
- Keywords:
- atrial fibrillation; radiofrequency catheter ablation; left atrial function; left atrial structure; ultrasonic cardiography
- 分类号:
- R541.7
- DOI:
- -
- 文献标识码:
- A
- 摘要:
- 目的:观察射频消融术对阵发性和持续性心房颤动（房颤）患者左心房结构和功能不同时期的影响。方法： 临床诊断房颤的79名患者作为研究对象（阵发性房颤组65例、持续性房颤组14例），随访1年，行超声心动图检查监测左心房最大面积（左心房左右径×上下径）、左心房最大容积（LAVmax）、左心房最小容积（ LAVmin）、左心房P容积（LAVp）等左心房结构指标，并通过左心房被动射血分数（LAPEF），左心房主动射血分数（LAAEF），左心房排空容积等指标探讨左心房功能的变化。体检非房颤人群22例作为对照组。全部数据采用SPSS17.0软件包进行统计学分析。结果： ①消融术前检测显示：房颤组左心房最大面积、LAVmax、LAVmin均高于正常对照组（P<0.05）；并且持续性房颤组左心房增大更显著（P<0.05）。房颤组LAAEF低于正常对照组（P<0.05），其中持续性房颤组下降更明显（P<0.05）。LAPEF及左心房排空容积各组间差异无统计学意义。②两组房颤患者术后左心房最大面积、LAVmax较术前均有变小（P<0.05），但两者出现变化的时间点不同，阵发性房颤组在术后1年明显变小（P<0.05），持续房颤组在术后近期就出现明显变小（P<0.05）。两组LAAEF、LAPEF、排空容积等较术前均无显著性变化。③持续性房颤组左心房最大面积术后近期、中期变化率大于阵发性房颤组(P<0.05)，但至术后1年变化率两者差异无统计学意义。结论： 经导管射频消融术能缩小房颤患者增大的左房结构，近、中期在持续性房颤患者更加显著；经导管射频消融术本身对左心房功能无明显影响。
- Abstract:
- AIM:To study the short- and long-term effects of radiofrequency catheter ablation on the left atrial structure and functions in patients with paroxysmal and persistent atrial fibrillation (AF) after radiofrequency ablation. METHODS: Transthoracic echocardiogram was performed in 79 patients with AF (65 cases in paroxysmal AF group and 14 cases in persistent AF group) at 1-3 days preoperation and 3, 6-9, and 12 months postoperation. Left atrial structure indexes were observed including the largest area of the left atrium (left atrial inferosuperior dimension×mediolateral dimension), the maximum volume of left atrium (LAVmax), the minimum volume of left atrium (LAVmin), and left atrial P volume (LAVp). The changes of left atrial functions were examined by calculating the left atrium passive ejection fraction (LAPEF), left atrial active ejection fraction (LAAEF), and left atrial emptying volume. Twenty-two cases without AF served as the control group. RESULTS: Preoperatively, the maximum left atrial area, the maximum left atrial volume and the minimum left atrial volume in the AF group were significantly larger than in the control group, with the indexes in the persistent AF group significantly higher than those in the paroxysmal AF group (P<0.05). The level of active ejection fraction in AF group was significantly lower than in the control group with the index in the persistent AF group significantly lower than in the paroxysmal AF group (P<0.05). There was no significant difference between passive ejection fraction and emptying volume between groups. Postoperatively, the size of the left atrial maximum area and the maximum left atrial volume decreased in both paroxysmal AF group and persistent AF group, but the changes occurred at different timepoints. The size in the paroxysmal AF group became significantly smaller (P<0.05) at 12 months postoperatively, whereas the size in the persistent AF group became significantly smaller (P<0.05) at 3 months postoperatively. There was no statistical significance in the changes of active ejection fraction, passive ejection fraction and emptying volume between groups. The short- and medium-term change rate of the postoperative maximum left atrial area in the persistent AF group was higher than in the paroxysmal AF group (P<0.05), but the difference of the change rate was not statistically significant at 12th months. CONCLUSION: Radiofrequency catheter ablation in patients with AF could reduce the increased left atrial structure, persistent AF more significantly in the short- and medium- term.Radiofrequency catheter ablation itself could not affect the left atrial function.
参考文献/References
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备注/Memo
- 备注/Memo:
- 收稿日期：2013-08-27.
通讯作者：徐瑾，副主任医师，主要从事心脏起搏电生理研究Email:glad-xujin@163.com
作者简介：李晓静，主治医师，硕士生Email：niangaomm5710@sina.com
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