Ellis Ethan R, Weaver Chayce, Loffler Adrian, Trivedi Amar
Medical Center of the Rockies, University of Colorado Health, 2121 East Harmony Rd, Suite 100, Fort Collins, CO, 80528, USA.
University of Colorado School of Medicine, Aurora, CO, USA.
J Interv Card Electrophysiol. 2025 Feb 13. doi: 10.1007/s10840-025-02008-9.
Pulmonary vein isolation (PVI) is a cornerstone of AF ablation. Posterior wall isolation (PWI) has become a frequently used adjunct to PVI. While there is data to suggest that PVI alone does not negatively impact left atrial function, the effect of PWI on left atrial mechanical function has not been definitively determined. Our aim was to determine if PVI plus PWI using a cryoballoon impacted left atrial mechanical function as measured by cardiac MRI.
We studied 28 patients who underwent ablation for AF. Fourteen patients had PVI alone and 14 patients had PVI plus PWI. All patients had cardiac magnetic resonance (CMR) before and after ablation. The primary outcome was change in LA ejection fraction (LAEF) as measured by CMR.
There were no statistically significant differences in the average patient age, height, weight, type of AF, or frequency of concomitant diseases between groups. No statistically significant differences in LAEF, LA max volume, LA min volume, or LA stroke volume were identified between baseline and follow up CMRs for the PVI only group nor the PVI plus PWI group. When utilizing linear regression analysis to compare change in LAEF, LA max volume, LA min volume, and LA stroke volume before and after ablation between groups, no statistically significant differences were identified.
Cardiac MRI did not demonstrate a significant change in left atrial mechanical function as measured by left atrial ejection fraction after pulmonary vein isolation alone nor after PVI plus posterior wall isolation.
肺静脉隔离（PVI）是房颤消融的基石。后壁隔离（PWI）已成为PVI常用的辅助手段。虽然有数据表明单独的PVI不会对左心房功能产生负面影响，但PWI对左心房机械功能的影响尚未明确确定。我们的目的是确定使用冷冻球囊进行PVI加PWI是否会影响通过心脏MRI测量的左心房机械功能。
我们研究了28例接受房颤消融的患者。14例患者仅接受PVI，14例患者接受PVI加PWI。所有患者在消融前后均进行了心脏磁共振（CMR）检查。主要结局是通过CMR测量的左心房射血分数（LAEF）的变化。
两组之间患者的平均年龄、身高、体重、房颤类型或合并疾病的频率没有统计学上的显著差异。仅PVI组和PVI加PWI组在基线和随访CMR之间，LAEF、左心房最大容积、左心房最小容积或左心房搏出量均未发现统计学上的显著差异。在使用线性回归分析比较两组消融前后LAEF、左心房最大容积、左心房最小容积和左心房搏出量的变化时，未发现统计学上的显著差异。
心脏MRI未显示单独肺静脉隔离后或PVI加后壁隔离后，通过左心房射血分数测量的左心房机械功能有显著变化。
