Kiliszek Marek, Miązek Nina, Peller Michał, Gajda Sylwia, Koźluk Edward, Lodziński Piotr, Kapłon-Cieślicka Agnieszka, Piątkowski Radosław, Budaj-Fidecka Anna, Balsam Paweł, Opolski Grzegorz
1st Chair and Department of Cardiology Medical University of Warsaw.
Kardiol Pol. 2014;72(11):1135-40. doi: 10.5603/KP.a2014.0135. Epub 2014 Jul 8.
Atrial fibrillation (AF) is the most frequent sustained supraventricular tachyarrhythmia. Radiofrequency (RF) ablation is one of the options used to prevent the recurrence of AF. Despite thorough studies, the relation between left atrial (LA) size and the results of RF ablation remains controversial.
To estimate the relation between LA size assessed by echocardiography and the AF recurrence rate after pulmonary vein isolation (PVI).
Our analysis comprised 175 AF patients subjected to PVI between June 2011 and March 2012. Inclusion criteria comprised: symptomatic AF with no reversible cause, and age < 70, LA < 5.5 cm (anteroposterior). PVI was performed with a 4-mm non-irrigated catheter or irrigated catheter and circular mapping catheter (electroanatomic mapping with LocaLisa or CARTO systems). Recurrence was defined as any atrial tachyarrhythmia episode that lasted more than 30 s after three months of blanking period. Standard echocardiographic post-ablation anteroposterior LA measurements were performed with additional parameters such as systolic and diastolic LA area and volume (on sinus rhythm).
The analysis included 198 procedures performed in 175 patients. Median follow-up time was 17 months. Median age was 56 years. After the first procedure, AF recurred in 88 (52.4%) patients. Efficacy after the last procedure was 55.2% (43.5% for persistent AF and 59.7% for paroxysmal AF). No significant relation between any of the LA parameters and the recurrence rate was found. Cox univariate and multivariate analysis revealed only very early AF recurrence as a prognostic factor for AF recurrence in the long term.
In patients with AF, no relation could be observed between the recurrence rate after PVI and the echocardiographic LA measurement parameters.
心房颤动（AF）是最常见的持续性室上性快速心律失常。射频（RF）消融是用于预防AF复发的选择之一。尽管进行了深入研究，但左心房（LA）大小与RF消融结果之间的关系仍存在争议。
评估经超声心动图评估的LA大小与肺静脉隔离（PVI）后AF复发率之间的关系。
我们的分析包括2011年6月至2012年3月期间接受PVI的175例AF患者。纳入标准包括：有症状的AF且无可逆病因，年龄<70岁，LA<5.5 cm（前后径）。使用4毫米非灌注导管或灌注导管及环形标测导管进行PVI（使用LocaLisa或CARTO系统进行电解剖标测）。复发定义为在空白期3个月后持续超过30秒的任何房性快速心律失常发作。在窦性心律下，采用标准超声心动图测量消融后LA前后径，并测量舒张期和收缩期LA面积及容积等其他参数。
分析包括对175例患者进行的198次手术。中位随访时间为17个月。中位年龄为56岁。首次手术后，88例（52.4%）患者AF复发。最后一次手术后的有效率为55.2%（持续性AF为43.5%，阵发性AF为59.7%）。未发现任何LA参数与复发率之间存在显著关系。Cox单因素和多因素分析显示，仅极早期AF复发是AF长期复发的预后因素。
在AF患者中，未观察到PVI后复发率与超声心动图LA测量参数之间的关系。
