The Changes Of Left Atrial Structure And Function After Radiofrequency Catheter Ablation In 43 Patients With Atrial Fibrillation

Purpose:Atrial fibrillation is the most common persistent arrhythmia in the clinic.Radiofrequency ablation,as the main treatment optionsforpatientswithatrial fibrillation,is used in most major hospitals around the world.However,there is still much to learn the mechanisms of recovery and long-term outcomes.In this study,two-dimensional echocardiography was used to track the changes of left atrial structure and function in patients with atrial fibrillation treated with radiofrequency ablation.Methods:43 patients with atrial fibrillation who underwent transcatheter radiofrequency ablation in cardiology departments of Qiqihar First Hospital and the Second Affiliated Hospital of Harbin Medical University from July 2017 to November 2018 were enrolled.Echocardiography was performed three days before surgery,three days after surgery,three months after surgery,and six months after surgery.The left atrial structure parameters(LAAPD,LAMD,LASID)and function parameters(LAVmin,LAVmax,LAEF,E-PEAK,A-PEAK,E/A)were collected.By the end of follow-up,a total of 31 patients(72.1%)maintained sinus rhythm after surgery,and were set as non-recurrent group;12 patients(27.9%)had recurrence of atrial fibrillation and were set to relapse group.The recovery of left atrial structural and functional parameters was compared.Results:1.After radiofrequency ablation,the left atrial structure and function parameters in the non-recurrent group were significantly reduced at the beginning of the postoperative period,and gradually recovered and improved over time.The left atrial diameter(LAAPD,LAMD,LASID)and left atrial volume(LAVmin,LAVmax)increased 3 days after surgery,butLAEF,E peak,and A peak decreased compared with preoperative.With the extension of time,the left atrial function gradually recovered,the atrial inner diameter and left atrial volume gradually decreased,while LEAF,E peak The A peak began to rise,the structure and function of the left atrium became normal,and the overall function of the left atrium was improved.2.LAAPD,LASID,LAVmin,LAVmax,A-PEAK at 4 times were statistically significant;LAMD,E peak,and E/A ratio were not statistically different between 3 months and 6 months after surgery,but were superior to preoperative and postoperative 3 days,suggesting that the indicators should be measured until 3 months after surgery.LAEF is statistically significant until 6 months after surgery,suggesting that the improvement of left atrial ejection fraction is slower,and it is appropriate to be reviewed 6 months after surgery.3.In the end of study,12 patients had recurred atrial fibrillation(27.9%).The age of relapsed group(64.17±8.64)was older than that of the non-recurrent group(55.12±10.39).There was no significant difference in gender,BMI,concomitant disease and disease duration between the two groups(P>0.05).The left atrial structural parameters(LAAPD,LAMD,LASID)and LAVmax were lower in the recurrence group than in the recurrent group(P<0.05),and the A peak was higher than the recurrence group(P<0.05).There was no statistical difference in LAVmin,LAEF and E-peak between the two groups(P>0.05).4.In recurrent group,there were statistical differences in structural and functional parameters of the left atrium only 3 days after surgery,which mean LAAPD,LAMD,LASID,LAVmin,LAVmax,LAEF,E-PEAK,A-PEAK and E/A did not have significant change after RFCA.5.Compare the recovery of the non-recurrent group with the recurrence group at 6 months after operation,all structural and functional parameters were significantly different after treatment(P<0.05).Conclusion:1.Radiofrequency ablation is an effective method for the treatment of atrial fibrillation which can improve the left atrial structure parameters and function parameters.2.Left atrial structural parameters(LASID,LAMD,and LAAPD)and left atrial volume parameters(LAVmax and LAVmin)rise briefly after 3 days after surgery,after which decreased;other left atrial function parameters(LAEF,E peak,A peak and E/A ratio)decreased briefly 3 days after surgery,and then continued to increase.3.After radiofrequency ablation surgery in patients with atrial fibrillation,the left atrial structural and functional parameters are gradually recovering--follow-up of 6 months is a suitable time to evaluate left atrial recovery after radiofrequency ablation.4.For patients with postoperative recurrence of atrial fibrillation,radiofrequency ablation failed to improve the parameters of the left atrium of the patient,and there was no significant change before and after surgery.