Assessment Of The Effect Of Catheter Ablation On Left Heart Structure And Function In Patients With Atrial Fibrillation By Echocardiography

Objective:Echocardiography will be used to assess the changes of echocardiographic parameters in patients with atrial fibrillation(AF)underwent catheter ablation.To explore the effect of catheter ablation on left atrial(LA)and left ventricular(LV)structure and function in patients with AF and provide references for clinical treatment and prognosis evaluation.Methods:Patients with AF who underwent catheter ablation in the First Hospital of Jilin University between May 2019 and August 2019 were enrolled.The patients who did not relapse after ablation were divided into paroxysmal atrial fibrillation(PAF)group and persistent atrial fibrillation(PeAF)group according to the type of AF.Echocardiographic assessment was performed on the previous day of the ablation,and then 1 month,3 months after the ablation.Echocardiographic parameters were as follows: left atrial anterior-posterior diameter(LAAPD),left atrial left-right diameter(LALRD),left atrial superior-inferior diameter(LASID),left ventricular end-diastolic diameter(LVEDD)and left ventricular end-systolic diameter(LVESD).Real-time bi-plane image technology was used to measure left atrial maximal volume(LAVmax),left atrial minimal volume(LAVmin)and left atrial presystolic volume(LAVp).To calculate left atrial ejection fraction(LAEF),left atrial passive ejection fraction(LAPEF)and left atrial active ejection fraction(LAAEF).Real-time tri-plane image technology was used to measure left ventricular end-diastolic volume(LVEDV)and left ventricular end-systolic volume(LVESV).To calculate left ventricular ejection fraction(LVEF).To compare the changes of echocardiographic parameters before and after catheter ablation in each group and explore the effect of catheter ablation on LA and LV structure and function in different types of AF patients.Results:(1)A total of 31 patients who did not relapse after ablation completed the follow-up,including 20 patients with PAF(PAF group)and 11 patients with PeAF(PeAF group).There was no significant difference in gender,age,body mass index(BMI),duration,hypertension,diabetes mellitus and coronary heart disease between the PAF group and the PeAF group(P> 0.05).Preoperative BNP in the PeAF group was significantly higher than that in the PAF group(P<0.05).(2)Comparison of preoperative echocardiographic data between the PAF group and the PeAF group: LAAPD,LALRD,LASID,LAVmax,LAVmin and LVESV in the PeAF group were larger than those in the PAF group(P <0.05).LAEF and LVEF in the PeAF group were significantly lower than those in the PAF group(P <0.05).There was no significant difference in remaining echocardiographic parameters between two groups(P> 0.05).(3)The PAF group: There was no significant difference in echocardiographic parameters between baseline and 1 month follow-up(P>0.05).LVEDD decreased at 3 months follow-up compared with preoperative LVEDD(P <0.05).There was no significant difference in LVEDD between 1 month follow-up and 3 months follow-up(P>0.05).LAAPD,LALRD,LASID,LAVmax,LAVmin,LAVp,LVESD,LVESV and LVEDV decreased at 3 months follow-up compared with those at baseline and 1 month follow-up(P<0.05).There was no significant difference in LAPEF,LAAEF,LAEF and LVEF at 3 months follow-up compared with those at baseline and 1 month follow-up(P>0.05).(4)The PeAF group: LAVmax,LAVmin,LVESV and LVEDV decreased at 1 month follow-up compared with those at baseline(P<0.05).LAEF and LVEF increased at 1 month follow-up compared with those at baseline(P<0.05).There was no significant difference in remaining echocardiographic parameters between baseline and 1 month follow-up(P>0.05).LAAPD,LALRD and LVESD decreased at 3 months follow-up compared with those at baseline(P<0.05).LVEF increased at 3 months follow-up compared with that at baseline(P<0.05).There was no significant difference in LAAPD,LALRD,LVESD and LVEF between 1 month follow-up and 3 months follow-up(P>0.05).LASID,LAVmax,LAVmin,LVEDD,LVESV and LVEDV decreased at 3 months follow-up compared with those at baseline and 1 month follow-up(P<0.05).LAVp decreased at 3 months follow-up compared with that at 1 month follow-up(P<0.05).LAEF increased at 3 months follow-up compared with that at baseline and 1 month follow-up(P<0.05).There was no significant difference in LAPEF and LAAEF between 1 month follow-up and 3 months follow-up(P>0.05).Conclusions:The extent of LA enlargement and the impairment of LA and LV systolic functions in PeAF patients were more severe than those in PAF patients.Catheter ablation could reverse the LA and LV structure remodeling in PeAF patients and PAF patients,and LA and LV significantly decreased.The improvement of LA and LV functions in PeAF patients was more obvious,while that in PAF patients was not significantly obvious.