Left Atrial Remodeling After Catheter Ablation In Patients With Paroxysmal Atrial Fibrillation

Objective: Atrial fibrillation is the most common clinical arrhythmia,Paroxysmal atrial fibrillation(PAF)happens a lot.There are many treatment options for this kind of disease.Long-term atrial fibrillation causes structural remodeling and electrical remodeling in the atrium.At present,this kind of research is common,however,there is not much research on the combination of atrial structure and electrical reconstruction.This study investigated the changes of left atrial remodeling parameters after catheter ablation in patients with paroxysmal atrial fibrillation using two-dimensional speckle tracking(2D-STI)and electrocardiographic analysis,and compared the changes of atrial remodeling in different treatment plans compared with conservatively treated patients.Methods:From June 2016 to December 2016 in Qingdao University Affiliated Hospital,randomly selected 55 cases of paroxysmal atrial fibrillation and 10 cases of non-atrial fibrillation patients undergoing catheter ablation,30 patients with paroxysmal atrial fibrillation including catheter ablation,edited into surgery group;25 conservative patients edited in the conservative treatment group.At the same time,selected 10 patients with paroxysmal supraventricular tachycardia(PSVT),premature ventricular contractions or pre-excitation syndrome(WPW)who underwent catheter ablation and edited them in the control group.Three groups of patients were reviewed for echocardiography,electrocardiogram,and 12-channel dynamic electrocardiograms at the time of admission,six months after catheter ablation,and one year after operation.Then we analyzed whether there were differences in cardiac structure,electrical remodeling and recurrence between patients undergoing catheter ablation and conservative treatment.Results: 1.The changes of left atrial volume,left atrial overall strain,and maximum strain rate during systolee: There was no significant difference in left atrial volume,left atrial diameter,and postoperative one year in the surgical group(P>0.05);Left atrial overall strain,systolic maximum strain rate preoperatively,postoperative one year have significant differences(P<0.05).Left atrial volume,left atrial diameter,left atrial overall strain,and systolic maximum strain rate in the conservative group were significantly different on admission and 1 year later(P<0.05).Left atrial volume,left atrial diameter,left atrial overall strain,and systolic maximum strain rate in the control group were not significantly different after 1 year of admission.The left atrial volume,left atrial diameter,left atrial overall strain,and systolic maximum strain rate were significantly different between the surgery group and the conservative treatment group after 1 year of follow-up(P<0.05).2.P wave changes(Pmax?Pmean?Pdis):Pmax,Pmean,and Pdis in the surgery group were significantly different before surgery and 1 year after surgery(P<0.05).The Pmax,Pmean,and Pdis in the conservative treatment group were significantly different before surgery and 1 year after surgery(P<0.05).The P wave in the control group did not change significantly and there was no significant difference(P>0.05).Comparing the P wave changes between the surgery group and the conservative treatment group after one year of follow-up,there was a significant difference(P<0.05).3.Compared the recurrences of the surgical and conservative treatment within 1 year,P<0.05,which means there are significant differences.Conclusion: Patients with paroxysmal atrial fibrillation have improved left atrial remodeling after catheter ablation,and the overall strain of the left atrium and the maximum strain rate during systole increase,and the P wave value decreases,reflecting the improvement of left atrial function.However,left atrial volume and diameter did not change significantly during the follow-up period,indicating that the strain and strain rate can better reflect the early changes in atrial remodeling,which means spot tracking is more reflective of changes in atrial remodeling than common Doppler techniques;in the corresponding conservative treatment group,the reconstruction of the left atrium gradually progressed,and some patients progress to persistent atrial fibrillation,Comparison of the incidence of atrial fibrillation within one year shows that the incidence of atrial fibrillation is lower in the surgical treatment group than in the conservative treatment group.This study found that in the treatment of patients with paroxysmal atrial fibrillation,in addition to controlling risk factors for atrial fibrillation,early cardiac rhythm control interventions should be used to early suppress the occurrence and progression of atrial remodeling,which can improve the prognosis of these patients in the long term,improve patient's quality of life,reduce the cost of disease treatment.