Department of Interventional Cardiology and Arrhythmology, National Scientific Center of Surgery named after A.N. Syzganov, Almaty, Republic of Kazakhstan.
Department of Health Policy and Organization, Al-Farabi Kazakh National University, Almaty, Republic of Kazakhstan.
Int J Clin Pract. 2021 Jun;75(6):e14083. doi: 10.1111/ijcp.14083. Epub 2021 Mar 2.
Enlarged left atrium is an established predictor of atrial fibrillation recurrence after pulmonary vein isolation but arrhythmia recurrence is also observed in patients with normal anatomy of the left atrium. The aim of the study is to evaluate arrhythmia recurrence predictors in patients with normal anatomy of the left atrium.
The study included 182 patients with normal anatomy of the left atrium who underwent pulmonary vein isolation using catheter ablation. Various parameters were also compared, including age, gender, history of arrhythmia, arterial hypertension, concomitant coronary pathology, echocardiography findings, such as mitral valve and tricuspid valve regurgitation and procedure parameters, between patients with and without relapses. Statistical analysis was performed using the IBM SPSS Statistics-19 software.
Transthoracic echocardiography was performed by independent specialists with extensive experience. Trans-esophageal echocardiography was performed before each ablation procedure. Standard trans-septal puncture was performed under fluoroscopic control. Radiofrequency ablation was performed in the ipsilateral pulmonary vein antrum with a wide capture of nearby lung tissue.
It was concluded that the tricuspid valve regurgitation and arterial hypertension correlate with atrial fibrillation recurrence after pulmonary vein isolation in patients with normal left atrial anatomy.
左心房增大是肺静脉隔离后心房颤动复发的既定预测指标,但在左心房解剖结构正常的患者中也观察到心律失常复发。本研究旨在评估左心房解剖结构正常患者的心律失常复发预测因素。
本研究纳入了 182 例接受导管消融肺静脉隔离的左心房解剖结构正常的患者。比较了患者有无复发的各种参数,包括年龄、性别、心律失常史、动脉高血压、并存的冠状动脉病变、超声心动图发现,如二尖瓣和三尖瓣反流以及手术参数。使用 IBM SPSS Statistics-19 软件进行统计分析。
经胸超声心动图由经验丰富的独立专家进行。在每次消融术前均进行经食管超声心动图检查。在透视控制下进行标准经间隔穿刺。在同侧肺静脉窦内进行射频消融,同时广泛捕获附近的肺组织。
研究得出结论,三尖瓣反流和动脉高血压与左心房解剖结构正常的患者肺静脉隔离后心房颤动复发相关。