Predictive Value Of Left Atrial Appendage Function In Recurrence Of Catheter Ablation Of Paroxysmal Atrial Fibrillation

Objective:To investigate the predictive value of left atrial appendage function in patients with recurrence of catheter ablation of paroxysmal atrial fibrillation.Methods:Patients with paroxysmal atrial fibrillation who underwent atrial fibrillation catheter ablation at the First Affiliated Hospital of China Medical University from April 2017 to October 2018 were enrolled.The general clinical data and test results of the patients were collected before ablation.Ventricular and atrial function were evaluated by transthoracic echocardiography(TTE),and left atrial appendage function was evaluated by transesophageal echocardiography(TEE).All patients were followed up after atrial fibrillation ablation.According to whether the atrial fibrillation recurred 3 months after the operation,the patients were divided into recurrence group and non-recurrece group.The clinical data of the two groups were statistically analyzed to confirm clinical factors affecting postoperative recurrenceResults: 1.109 patients with atrial fibrillation,16 patients had recurrence,and baseline data were compared between the recurrencc and non-recurrence groups:CHA2DS2-VASc score(1.78±1.25 vs 1.33±0.92,P=0.02).The difference was significant.The remaining baseline data did not differ significantly between the two groups.2.Compared with the non-recurring group,the left atrial appendage blood flow velocity(35.81±10.55cm/s vs 55.66±27.48cm/s,P=0.01)decreased,and the left atrial appendage area contract rate decreased(0.45±0.18 vs 0.57±0.13,P=0.02)decreased,the left atrial appendage minimum area(2.39±1.08 cm2 vs 1.56±0.94 cm2,P=0.01)increased,left atrial MR-proANP(169.84±113.23pg/ml vs 73.10±47.89pg/ml,P=0.004)increased,the spontaneous development rate of left atrial appendage(12% vs 0%,P=0.001)increased,the difference was significant.Multivariate logistic regression analysis showed that left atrial appendage blood flow velocity,left atrial appendage area change rate,CHA2DS2-VASc score,and left atrialMR-proANP were independent risk factors for atrial fibrillation recurrence after ablation in patients with paroxysmal atrial fibrillation(P<0.05)Conclusion: The left atrial appendage area change rate,left atrial appendage blood flow velocity,MR-proANP in left atrial and CHA2DS2-VASc score are important indicators for predicting recurrence after ablation in patients with paroxysmal atrial fibrillation.