| Objective: The changes of left ventricular structure and function in patients with atrial fibrillation after simple radiofrequency catheter ablation or catheter ablation combined with left atrial appendage occlusion were evaluated by real-time three-dimensional echocardiography and two-dimensional speckle tracking echocardiography.Methods: This study prospectively collected patients with atrial fibrillation who were hospitalized in a municipal people’s hospital from November 2021 to November 2022and planned to undergo surgical treatment,excluding those who lost follow-up or were difficult to be admitted for examination due to the epidemic.Finally,64 patients were included in this study,including 34 patients in the simple radiofrequency catheter ablation treatment group and 30 patients in the one-step operation treatment group(catheter ablation combined with left atrial appendage occlusion).The general clinical data such as age,sex,height,and the echocardiographic data before,1 month and 3 months after operation were collected.The left ventricular end-diastolic dimension(LVEDD)and left ventricular end-systolic dimension(LVESD)were measured by conventional transthoracic echocardiography,and the left ventricular ejection fraction(LVEF)was measured by modified biplane Simpson method.The left ventricular end-diastolic volume(LVEDV),left ventricular end-systolic volume(LVESV)and LVEF(RT-3DE automatic quantification method)were measured by real-time three-dimensional echocardiography(RT-3DE).Two-dimensional speckle tracking echocardiography(2D-STE)was used to measure the longitudinal strain(LS)of apical two-chamber heart(AP2),apical threechamber heart(AP3),apical four-chamber heart(AP4)and global longitudinal strain(GLS)of left ventricle.Results:1.The EDV(RT-3DE automatic quantitative method)in the simple radiofrequency catheter ablation group was smaller than that in the one-step operation group one month after the operation,and the difference was statistically significant.The EDV(RT-3DE automatic quantitative method)in the simple radiofrequency catheter ablation group was smaller than that in the one-step operation group at 3 months after operation,and the difference was statistically significant.The LVEF(RT-3DE automatic quantitative method),LS-AP2,LS-AP3,LS-AP4 and GLS in the simple radiofrequency catheter ablation group were significantly higher than those in the one-step operation group at 3months after operation.2.The LVEDD,LVESD,EDV(RT-3DE automatic quantification)and ESV(RT-3DE automatic quantification method)of patients in the simple radiofrequency catheter ablation group were significantly smaller than those before operation,and LVEF(Simpson method),LVEF(RT-3DE automatic quantification method),LS-AP2,LS-AP3,LS-AP4 and GLS were significantly higher than those before operation.Compared with1 month after operation,all echocardiographic parameters were statistically different(P<0.05).3.The LVEDD,LVESD and ESV(RT-3DE automatic quantification method)of patients in one-step operation group were significantly decreased one month after operation,and LVEF(Simpson method),LVEF(RT-3DE automatic quantification method),LS-AP4 and GLS were significantly increased compared with those before operation,with statistically significant difference.The LVEDD,LVESD,EDV(RT-3DE automatic quantitative method)and ESV(RT-3DE automatic quantitative method)were significantly reduced in3 months after operation compared with those before operation,the LVEF(Simpson method),LVEF(RT-3DE automatic quantitative method),LS-AP2,LS-AP4 and GLS were significantly increased compared with those before operation,and the difference was statistically significant.The LVEDD,LVESD and EDV(RT-3DE automatic quantitative method)in 3 months after operation were significantly smaller than that in 1month after operation,and the LVEF(Simpson method)was significantly higher than that in 1 month after operation,and the difference was statistically significant.Conclusion:1.The left ventricular structure and function of patients in simple radiofrequency catheter ablation group and one-step operation group were significantly improved after operation.2.The improvement of left ventricular structure and function in the simple radiofrequency catheter ablation group was more prominent than that in the one-step operation group.3.Real-time three-dimensional echocardiography combined with two-dimensional speckle tracking echocardiography can early predict the changes of left ventricular structure and function. |
