| Objectives:To evaluate the effect of Catheter Ablation on cardiac function in patients with atrial fibrillation and ventricular diastolic dysfunction.Method:A analysis was conducted from September 2019 to September2020 in patients with atrial fibrillation associated with ventricular diastolic dysfunction who underwent catheter ablation in four departments of cardiology at the Second Hospital of Hebei Medical University.For patients with symptomatic atrial fibrillation who did not respond to antiarrhythmic therapy,left atrium without thrombosis,age ≥ 65 years old,E/e’≥13,EF≥50% and good compliance will be selected.The basic information of patients was recorded by medical history collection and consulting the inpatient medical records.All patients were required to do the following preoperative preparation: stop using antiarrhythmic drugs for at least 5 half lives;At least 4 weeks or 48 hours before anticoagulation,transesophageal echocardiography or pulmonary vein CT were performed to exclude left atrial thrombosis;Complete routine examination;In the second Department of echocardiography,Second Hospital of Hebei Medical University,the same doctor performed echocardiography with Philip EPIQ 7C evolution 3.0 color echocardiography;All patients signed the informed consent of operation.All patients were performed radiofrequency ablation or cryoablation by the same surgeon.All patients were treated with anticoagulants,antiarrhythmic drugs for 3 months and proton pump inhibitors for 1 month.All patients were divided into success group and recurrence group according to whether atrial fibrillation recurred 3 months after operation.If no tachyarrhythmia lasting more than 30 s was found in body surface electrocardiogram and dynamic electrocardiogram 3 months after operation,patients entered success group,otherwise they entered recurrence group.At the same time,we followed up the E/e’values of the successful group and the recurrence group at the third month after operation.The changes of E/e’value before and after operation was analyzed and compared between the two groups.Results:From September 2019 to September 2020,89 patients met the inclusion criteria and were included in the study.The average follow-up time was 3.21±0.79 months,12 cases(13.5%)were lost to follow-up,and the final sample size was 77 cases.There were 66 cases(83.3%)in the success group,11 cases(16.7%)in the recurrence group,and no major cardiovascular adverse events occurred.1.There was no significant difference in age,BMI,hypertension,coronary heart disease,smoking history,drinking history and paroxysmal AF between the two groups(P > 0.05).There was no significant difference in creatinine,GHB,LDL-C,BNP and EF between the two groups(P > 0.05).2.The E/e’ratio before catheter ablation in success group was 17.69±4.17,the E/e’ratio before catheter ablation in recurrence group was 19.26±3.72.There was no significant difference between the two groups(P > 0.05).The E/e’ratio after catheter ablation in success group was 14.43±5.09,the E/e’ratio after catheter ablation in recurrence group was 19.62±3.82,which was a statistical difference(P < 0.05).3.In success group,the E/e’ratio before catheter ablation was 17.69±4.17,the E/e’ ratio after catheter ablation was 14.43± 5.09.the E/e’difference was 3.26±3.55,which was a statistical difference(P < 0.05).In recurrence group,the E/e’ratio before catheter ablation was 19.26±3.72,the E/e’ratio after catheter ablation was 19.62±3.82,the E/e’difference was-0.36±1.41.There was no statistical difference(P > 0.05).Conclusion: Catheter ablation can reduce E/e’ratio in patients with atrial fibrillation and ventricular diastolic dysfunction.However,unsuccessful catheter ablation does not worsen ventricular diastolic function in patients with atrial fibrillation. |
