房颤导管消融术后心脏 MRI 评估左心耳隔离：心耳储器的悖论。
Evaluation of Left Atrial Appendage Isolation Using Cardiac MRI after Catheter Ablation of Atrial Fibrillation: Paradox of Appendage Reservoir.
机构信息
Department of Radiology, Korea University Anam Hospital, Seoul, Korea.
Division of Cardiology, Department of Internal Medicine, Korea University Anam Hospital, Seoul, Korea.
出版信息
Korean J Radiol. 2021 Apr;22(4):525-534. doi: 10.3348/kjr.2020.0629. Epub 2020 Nov 19.
OBJECTIVE
To assess the effect of left atrial appendage (LAA) isolation on LAA emptying and left atrial (LA) function using cardiac MRI in patients who underwent successful catheter ablation of atrial fibrillation (AF).
MATERIALS AND METHODS
This retrospective study included 84 patients (mean age, 59 ± 10 years; 67 males) who underwent cardiac MRI after successful catheter ablation of AF. According to the electrical activity of LAA after catheter ablation, patients showed either LAA isolation or LAA normal activity. The LAA emptying phase (LAA-EP, in the systolic phase [SP] or diastolic phase), LAA emptying flux (LAA-EF, mL/s), and LA ejection fraction (LAEF, %) were evaluated by cardiac MRI.
RESULTS
Of the 84 patients, 61 (73%) and 23 (27%) patients showed LAA normal activity and LAA isolation, respectively. Incidence of LAA emptying in SP was significantly higher in LAA isolation (91% vs. 0%, < 0.001) than in LAA normal activation. LAA-EF was significantly lower in LAA isolation (40.1 ± 16.2 mL/s vs. 80.2 ± 25.1 mL/s, < 0.001) than in LAA normal activity. Furthermore, LAEF was significantly lower in LAA isolation (23.7% ± 11.2% vs. 31.1% ± 16.6%, = 0.04) than in LAA normal activity. Multivariate analysis demonstrated that the LAA-EP was independent from LAEF ( = 0.01).
CONCLUSION
LAA emptying in SP may be a critical characteristic of LAA isolation, and it may adversely affect the LAEF after catheter ablation of AF.
目的
评估左心耳（LAA）隔离对成功接受导管消融治疗心房颤动（AF）患者的 LAA 排空和左心房（LA）功能的影响。
材料和方法
本回顾性研究纳入了 84 名患者（平均年龄 59 ± 10 岁；67 名男性），这些患者在成功接受导管消融 AF 后接受了心脏 MRI 检查。根据导管消融后 LAA 的电活动，患者表现出 LAA 隔离或 LAA 正常活动。通过心脏 MRI 评估 LAA 排空期（LAA-EP，在收缩期[SP]或舒张期）、LAA 排空流量（LAA-EF，mL/s）和 LA 射血分数（LAEF，%）。
结果
84 名患者中，61 名（73%）和 23 名（27%）患者分别表现出 LAA 正常活动和 LAA 隔离。LAA 隔离患者 LAA 在 SP 排空的发生率明显高于 LAA 正常激活（91% vs. 0%， < 0.001）。LAA-EF 在 LAA 隔离患者明显低于 LAA 正常活动（40.1 ± 16.2 mL/s vs. 80.2 ± 25.1 mL/s， < 0.001）。此外，LAA 隔离患者的 LAEF 明显低于 LAA 正常活动（23.7% ± 11.2% vs. 31.1% ± 16.6%， = 0.04）。多变量分析表明，LAA-EP 与 LAEF 独立（ = 0.01）。
结论
SP 中的 LAA 排空可能是 LAA 隔离的一个关键特征，并且可能对 AF 导管消融后 LAEF 产生不利影响。
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