Soysal Ali Ugur, Ozturk Sila, Onder Sukriye Ebru, Atici Adem, Tokdil Hasan, Raimoglu Utku, Gulfidan Asli, Yalman Hakan, Durmaz Eser, Ikitimur Baris, Yalin Kivanc
Department of Cardiology, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey.
Cerrahpasa School of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey.
Pacing Clin Electrophysiol. 2023 Aug;46(8):861-867. doi: 10.1111/pace.14771. Epub 2023 Jun 28.
In patients with paroxysmal atrial fibrillation (PAF), functional changes are observed in the left atrium (LA) after pulmonary vein isolation (PVI) procedure. Although previous studies have investigated the altered mechanical functions of the LA with radiofrequency (RF) ablation, changes in the LA functions in the early period after cryoablation (CB-2) have not been clearly demonstrated. This study aims to explore the early periodical changes in mechanical functions of the LA in patients with PAF who underwent CB-2 based ablation through the help of echocardiographic methods which contain Doppler and strain parameters.
Consecutive 77 patients (mean age: 57.5 ± 11.2; 57% men) with PAF underwent CB-2 were prospectively analyzed. All patients were in sinus rhythm before and after the procedure. The LA dimensions, the LA reservoir strain, the LA atrial contractile strain and the LA conduit strain and left ventricular diastolic function parameters were evaluated by Doppler echocardiography before and 3 months after the procedure.
Acute procedural success was achieved in all cases. No major complications were observed. LA reservoir strain and LA contractile strain showed significant recovery after the procedure. (28.3 ± 12.8 vs. 34.6 ± 13.8, p < .001 and -10.8 ± 7.9 vs. -13.9 ± 9.3, p = .014 respectively). No significant change was demonstrated in other echocardiographic parameters.
Significant improvement in mechanical functions may occur even in the early period after cryoballoon ablation in patients with PAF.
阵发性心房颤动（PAF）患者在肺静脉隔离（PVI）术后左心房（LA）会出现功能变化。尽管先前的研究已经调查了射频（RF）消融术后左心房机械功能的改变，但冷冻消融（CB-2）术后早期左心房功能的变化尚未得到明确证实。本研究旨在通过包含多普勒和应变参数的超声心动图方法，探讨接受基于CB-2消融的PAF患者左心房机械功能的早期阶段性变化。
对连续77例接受CB-2的PAF患者（平均年龄：57.5±11.2；57%为男性）进行前瞻性分析。所有患者在手术前后均处于窦性心律。在手术前和术后3个月通过多普勒超声心动图评估左心房大小、左心房储存应变、左心房心房收缩应变、左心房管道应变和左心室舒张功能参数。
所有病例均取得急性手术成功。未观察到重大并发症。术后左心房储存应变和左心房收缩应变显示出显著恢复。（分别为28.3±12.8对34.6±13.8，p<.001；-10.8±7.9对-13.9±9.3，p=.014）。其他超声心动图参数未显示出显著变化。
PAF患者即使在冷冻球囊消融术后早期，其机械功能也可能出现显著改善。
