Atrial Fibrillation Accelerated Left Atrial Remodeling In Clinical Research

Objective:By analyzing and researching left atrial structure, P wave dispersion (Pd) and P waveduration in Patients with sinus rhythm, paroxysmal atrial fibrillation and persistent atrialfibrillation, It is hopeful to explore the relationship between atrial fibrillation (includingit’s occurrence and development) and left atrial structure, Pd and P wave durationchanges. It is hopeful to provide a method for the detection of early paroxysmal atrialfibrillation as a clinical monitor, and to guide clinical treatment for reducing theincidence of thromboembolic events in patients with paroxysmal atrial fibrillation.Method:We chose95cases of hospitalized patients during May2012to November2013inmy inner sections, which including:36patients (20males,16females) as the persistentAF group,the mean of whose age was63.42±7.00,19of who were with hypertension.12of who were with coronary heart disease,10of who are with valvular heart disease,9cases of who were with cardiomyopathy,12cases of who were with diabetes;27patients (18males,9females) as the paroxysmal atrial fibrillation group, the mean ofwhose age was63.42±6.18,15cases of who were with hypertension,10of who werewith coronary heart disease,8cases of who were with valvular heart disease,7cases ofwho were with cardiomyopathy,4cases of who were with diabetes.;32patients (20males,12females) as the Sinus rhythm group, the mean of whose age was61.00±5.90,18cases of who were with hypertension,13cases with coronary heart disease,13caseswith valvular heart disease,10cases with cardiomyopathy,12cases with diabetes. Allpatients with atrial fibrillation after admission must be diagnosed as paroxysmal atrialfibrillation or persistent atrial fibrillation after the examination of three ECG orHolterdiagnosis. After recovering by drugs treatment or electrical cardioversion, patients with persistent atrial fibrillation received the check of ECG, through which, we measuredP max, P min and Pd. Meanwhile we measured the diameter of the left atrium and atrialvolume size by echocardiography，and calculate the maximum atrial volume index.patients with the sinus rhythm were also received all the examination above too.Allpatients’ height, weight, body mass index (BMI) were measured too. All entrants mustdetect biochemical indicatorsResult:1. In the composition between the sinus rhythm group and paroxysmal AF group, theindex of age, height, weight, body mass，biochemical indicators showed no significantdifference in statistics (P>0.05). Table-3: P wave dispersion and P-wave maximum timein sinus rhythm group was (40.93±1.41VS38.84±1.67, P <0.01), in paroxysmal AFgroup is (110.44±3.71ms VS108.44±3.45ms, P <0.05). their differences werestatistically significant, indicating that degree of atrial heterogeneity and Atrial electricalconduction time limit in patients with paroxysmal atrial fibrillation were significantlyhigher than patients with the sinus rhythm. However, the minimum time limit of P-waveshowed no difference (69.52±3.61VS69.69±2.52, P>0.05), prompted atrialconduction between the two groups were no significant obstacles. LAD(37.11±3.22mmVS34.11±2.41mm, P <0.01), LAVImin (18.81±2.32cm3/m2VS17.34±2.77cm3/m2, P<0.05) and LAVImax (32.19±3.41cm3/m2VS30.50±3.01cm3/m2, P <0.05)of twogroups of patients showed that the severity of cardiac chambers extent in patients withparoxysmal atrial fibrillation was significantly higher than patients with sinus rhythm.2. In the composition between persistent atrial fibrillation group and paroxysmal AFgroup, the index of age, height, weight, body mass biochemical indicators showed nosignificant difference in statistics (P>0.05). P wave dispersion and P-wave maximumtime in persistent atrial fibrillation group was (70.36±3.20mm VS69.52±3.61mm，P>0.05), in paroxysmal AF group is (112.39±3.36mmVS110.44±3.71mm，P<0.05).Difference of later was statistically significant, indicating that degree of atrialheterogeneity and Atrial electrical conduction time limit in patients with persistent atrialfibrillation were higher than patients with paroxysmal atrial fibrillation，Atrial electricalconduction of the former was slower than the later. LAD(40.03±3.24mm VS 37.11±3.22mm，P<0.05), LAVImin (21.03±2.88cm3/m2VS18.81±2.32cm3/m2，P<0.05)and LAVImax (36.94±2.83cm3/m2VS32.19±3.14cm3/m2，P<0.05)of two groups ofpatients showed that the severity of cardiac chambers extent, the heterogeneity of atrialand atrial electrical conduction in patients with persistent atrial fibrillation weresignificantly higher than paroxysmal atrial fibrillation. It was said that as the time ofsustained atrial fibrillation prolonged,the severity of atrial remodeling aggravated.Conclusion:1Left atrium diameter、LeftAtrial Volume Index、P-wave dispersion、maximum timelimitis of patients with paroxysmal atrial fibrillation were higher than patients with sinusrhythm.2Left atrium diameter、LeftAtrial Volume Index、P-wave dispersion、the maximumlimit of patients with persistent atrial fibrillation were significantly higher than patientswith paroxysmal atrial fibrillation.3With the occurrence and development of atrial fibrillation,Left atrium diameter、LeftAtrial Volume Index, P-wave dispersion and P-wave maximum time limit also willchange.4the changes of structure of Left atrium diameter、the left atrial volume Index、P-wave dispersion and P-wave maximum time can be used to monitor the occurrence anddevelopment of atrial fibrillation.