Choi Jong-Il, Park Seong Mi, Park Jae Seok, Hong Soon Jun, Pak Hui-Nam, Lim Do Sun, Kim Young-Hoon, Shim Wan Joo
Division of Cardiology, Department of Internal Medicine, Korea University Hospital, Korea University College of Medicine, Seoul, Republic of Korea.
Circ J. 2008 Dec;72(12):2051-7. doi: 10.1253/circj.cj-08-0428. Epub 2008 Oct 24.
The aim of this study was to assess whether the morphological and functional changes of the left atrium (LA) differ after catheter ablation (ABL) from those after electrical cardioversion (ECV) in atrial fibrillation (AF).
AF patients who had maintained sinus rhythm for 3 months after either ECV (n=30) or ABL (n=33) were studied. Both 2-dimensional and Doppler echocardiography were performed at baseline, 1 week, 1 month, and 3 months after these procedures. LA dimensions, mitral inflow velocity, and tissue Doppler imaging of the mitral annulus were examined. LA dimensions decreased in both groups. The mean late mitral annulus velocity increased from 1 week to 3 months in both groups, but the mean late transmitral peak velocity increased only in the ECV group (42.1+/-14.4 cm/s to 56.7+/-14.8 cm/s, p<0.001 vs 38.7+/-12.5 cm/s to 44.8+/-16.7 cm/s, p=NS).
Reverse morphological remodeling of the LA occurred after successful ABL and ECV for AF. However, because LA function was lower in the ABL group than in the ECV group and did not recover to the baseline levels until 3 months after ABL, a meticulous anticoagulation program should be considered.
本研究旨在评估心房颤动（AF）患者经导管消融（ABL）后左心房（LA）的形态和功能变化是否与电复律（ECV）后不同。
研究了经ECV（n = 30）或ABL（n = 33）后维持窦性心律3个月的AF患者。在这些操作后的基线、1周、1个月和3个月进行二维和多普勒超声心动图检查。检查LA尺寸、二尖瓣流入速度和二尖瓣环的组织多普勒成像。两组的LA尺寸均减小。两组从1周到3个月二尖瓣环平均晚期速度均增加，但仅ECV组二尖瓣平均晚期峰值速度增加（从42.1±14.4 cm/s增至56.7±14.8 cm/s，p<0.001，而ABL组从38.7±12.5 cm/s增至44.8±16.7 cm/s，p =无显著性差异）。
AF患者成功进行ABL和ECV后，LA出现逆向形态重塑。然而，由于ABL组的LA功能低于ECV组，且直到ABL后3个月才恢复到基线水平，因此应考虑制定细致的抗凝方案。
