Mahrous Noha, Blaschke Florian, Schöppenthau Doreen, Hindricks Gerhard, Boldt Leif-Hendrik, Parwani Abdul Shokor
Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum Der Charité, 13353 Berlin, Germany.
Department of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum Der Charité, 13353 Berlin, Germany.
J Clin Med. 2024 Dec 26;14(1):68. doi: 10.3390/jcm14010068.
: Atrial fibrillation (AF) is a common cardiac arrhythmia associated with left atrial dysfunction. The impact of pulmonary vein isolation (PVI) using pulsed field ablation (PFA) on left atrial function has not been previously quantified. This study aims to evaluate the effects of PVI using PFA on left atrial function in patients with AF. : Thirty-four patients undergoing PVI with PFA between July 2022 and November 2023 were included. The left atrial function was assessed using echocardiography pre-procedure and at 6 months post-procedure. : The mean age of the patients was 66.5 ± 9.76 years, with 70.6% being male. The cohort included 44% of patients with paroxysmal AF. PVI was successfully achieved in all patients, with a significant improvement in all aspects of left atrial strain at an average of six-month follow-up. The left atrial strain reservoir (LASr) increased from 12.5 ± 5.8% to 21.7 ± 8.1% ( < 0.001). Notably, patients with paroxysmal AF exhibited a greater increase in LASr compared to those with persistent AF. Additionally, pre-procedural sinus rhythm was a significant predictor of better LASr outcomes. : PFA is associated with significant improvement in left atrial reservoir strain, suggesting a positive impact on atrial function. These findings have important implications for the therapeutic management of AF and warrant further research.
心房颤动（AF）是一种与左心房功能障碍相关的常见心律失常。先前尚未对使用脉冲场消融（PFA）进行肺静脉隔离（PVI）对左心房功能的影响进行量化。本研究旨在评估使用PFA进行PVI对AF患者左心房功能的影响。纳入了2022年7月至2023年11月期间接受PFA进行PVI的34例患者。在术前和术后6个月使用超声心动图评估左心房功能。患者的平均年龄为66.5±9.76岁，男性占70.6%。该队列包括44%的阵发性AF患者。所有患者均成功完成PVI，平均6个月随访时左心房应变的各个方面均有显著改善。左心房应变储备（LASr）从12.5±5.8%增加到21.7±8.1%（<0.001）。值得注意的是，与持续性AF患者相比，阵发性AF患者的LASr增加更大。此外，术前窦性心律是LASr预后较好的重要预测因素。PFA与左心房储备应变的显著改善相关，提示对心房功能有积极影响。这些发现对AF的治疗管理具有重要意义，值得进一步研究。
