Relationship Between the Changes of Left Atrium, Pulmonary Vein Ostia and AF Recurrence After Radiofrequency Catheter Ablation by Enhanced Cardiac MRI Evaluation
10.3969/j.issn.1000-3614.2018.04.018
- VernacularTitle:增强心脏磁共振成像评估心房颤动患者射频消融术后左心房及肺静脉开口变化与术后复发的关系
- Author:
Xue-Lian LI
1
;
Wen-Su CHEN
;
Cheng-Zong LI
;
Fei LI
;
Chao-Qun ZHANG
;
Shu-Guang HAN
;
Jia-Li WANG
;
Zhi-Rong WANG
;
Zhuo-Qi ZHANG
Author Information
1. 徐州医科大学附属医院 心内科
- Keywords:
Atrial fibrillation;
Left atrial remodeling;
Pulmonary vein;
Circumferential pulmonary vein isolation radiofrequency catheter ablation;
Enhanced cardiac MRI
- From:
Chinese Circulation Journal
2018;33(4):390-394
- CountryChina
- Language:Chinese
-
Abstract:
Objectives: To evaluate the changes of left atrial volume (LAV) and the maximum ostial cross-sectional area (CAS) of pulmonary vein (PV) in atrial fibrillation (AF) patients after circumferential pulmonary vein isolation radiofrequency catheter ablation (CPVA-RFCA) and to explore their relationship to AF recurrence by enhanced cardiac MRI evaluation. Methods: Our research included in 2 groups: Control group, n=20 healthy subjects and AF group, n=78 patients whom were classified into 2 subgroups as Paroxysmal AF subgroup, n=46 and Persistent AF subgroup, n=32; 66 patients received CPVA-RFCA and based on 6 months post-operative recurrence, they were divided into another set of 2 groups: AF recurrent subgroup, n=17 and Non-AF recurrent subgroup, n=49. Pre- and 6 months post-operative maximum ostial CSA of PV were measured by enhanced cardiac MRI, LAV were obtained by 3D reconstruction and the differences were compared between AF group and Control group, Paroxysmal AF subgroup and Persistent AF subgroup, AF recurrent subgroup and Non-AF recurrent subgroup; their relationships to AF recurrence were studied.Results: Compared with Control group, AF group had increased LAV and elevated ostial CSA of superior PV (SPV), both P<0.05. Compared with Paroxysmal AF subgroup, Persistent AF subgroup had increased LAV and elevated ostial CSA of SPV, both P<0.05. Compared with pre-operative condition, at 6 months after the operation, Non-AF recurrent subgroup showed reduced ostial CSAs in left SPV (LSPV), right SPV (RSPV), right inferior PV (RIPV) and decreased LAV, all P<0.05;while AF recurrent subgroup showed expanded RSPV and increased LAV,allP<0.05.Post-operative reductions of LAV and ostial CSA of SPV had close correlation; multivariate Logistic regression analysis indicated that LAV (HR=1.05, P<0.01)and ostial CSA of RSPV(HR=1.09,P=0.05)were related to AF recurrence after RFCA. Conclusions: CAPV-RFCA could reverse left atrial and PV remodeling in AF patients, LAV and ostial CSA of RSPV were related to post-operative AF recurrence.
