Comparisons of the underlying mechanisms of left atrial remodeling after repeat circumferential pulmonary vein isolation with or without additional left atrial linear ablation in patients with recurrent atrial fibrillation

详细信息    查看全文

• 作者：Chia-Hung Yang^a ; ¹ ; ² ; Chung-Chuan Chou^a ; ^b ; ¹ ; ² ; Kuo-Chun Hung^a ; ^b ; ² ; Ming-Shien Wen^a ; ^b ; ² ; Po-Cheng Chang^a ; ² ; Hung-Ta Wo^a ; ² ; Cheng-Hung Lee^a ; ^b ; ² ; Fen-Chiung Lin^a ; ^b ; ^{capful36@gmail.com}
• 关键词：Atrial fibrillation ; 2-D strain echocardiography ; Speckle-tracking echocardiography ; Radiofrequency ablation
• 刊名：International Journal of Cardiology
• 出版年：2017
• 出版时间：1 February 2017
• 年：2017
• 卷：228
• 期：Complete
• 页码：449-455
• 全文大小：253 K
• 卷排序：228

文摘

Radiofrequency catheter ablation (RFCA) is a potentially curative treatment for atrial fibrillation (AF), however, whether or not additional left atrial (LA) linear ablation for recurrent AF adversely affects LA remodeling is unknown.MethodsThirty-eight patients experiencing AF recurrence after the 1st circumferential pulmonary vein isolation (CPVI) underwent a repeat RFCA, including 20 and 18 patients receiving a repeat CPVI (group I) or CPVI plus LA linear ablation (group II), respectively. 2-D echocardiography was performed during sinus rhythm within 24 h, at 1-m and 6-m after RFCA. Longitudinal strains and strain rate were measured with speckle-tracking echocardiography. The standard deviation of contraction duration was defined as LA mechanical dispersion.ResultsOne and two patients experienced AF recurrence after the 2nd RFCA in group I and II, respectively (P = NS). The 1st CPVI with AF recurrence did not reduce LA size significantly in two groups. After a repeat CPVI, LA diameter but not LA maximal and minimal volume was significantly reduced in group I; additional LA linear ablation significantly decreased LA diameter, maximal and minimal volume in group II. However, there was no significant difference in LA emptying function, global and segmental LA strain and strain rate among the baseline, 1-m and 6-m follow-up in two groups. RFCA did not significantly increase LA mechanical dispersion regardless of the AF ablation strategies.ConclusionsIn patients with recurrent AF, a successful repeat CPVI with or without additional LA linear ablation reduced LA size without significant deleterious effects on LA function and mechanical dispersion.