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Predictive value of various Doppler-derived parameters of atrial conduction time for successful atrial fibrillation ablation

机译：房颤传导时间的多普勒衍生参数对成功进行房颤消融的预测价值

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Various Doppler-derived parameters of left atrial electrical remodeling have been demonstrated to predict recurrence of atrial fibrillation (AF) after AF ablation. The aim of this study was to compare three Doppler-derived measures of atrial conduction time in patients undergoing AF ablation, and to investigate their predictive value for successful procedure. In 32 prospectively enrolled patients undergoing the first AF ablation, atrial conduction time was estimated by measuring the time delay between the onset of P-wave on the surface ECG to the peak of the a′-wave on the pulsed-wave Doppler and color-coded tissue Doppler imaging of the left atrial lateral wall, and to the peak of the A-wave on the pulsed-wave Doppler of the mitral inflow. There was a significant difference in the baseline atrial conduction time measured by different echocardiographic techniques. Most (88%) patients had normal or only mildly dilated left atrium. At 6 months, 12 patients (38%) had recurrent AF/atrial tachycardia. The duration of history of AF was the only predictor of AF/atrial tachycardia recurrence following the first AF ablation (P=0.024; OR 1.023, CI 1.003–1.044). A combination of normal left atrial volume and history of paroxysmal AF of ≤48 months was associated with the best outcome. Predictive value of the Doppler derived parameters of atrial conduction time may be reduced in the early stages of left atrial remodeling. Future studies may determine which echocardiographic parameter correlates best with the extent of left atrial remodeling and is most predictive of successful AF ablation.
机译：左心房电重构的各种多普勒参数已被证明可预测房颤消融后房颤（AF）的复发。这项研究的目的是比较房颤消融患者的三种多普勒测量心房传导时间，并探讨其对成功手术的预测价值。在32位接受首次AF消融的预期入组患者中，通过测量表面ECG上的P波发作到脉冲多普勒仪上的a'波峰到彩色多普勒超声之间的时间延迟来估算心房传导时间。编码左心房侧壁的组织多普勒成像，以及二尖瓣流入的脉冲波多普勒上的A波峰值。通过不同的超声心动图技术测得的基线心房传导时间存在显着差异。大多数（88％）患者的左心房正常或仅有轻度扩张。在6个月时，有12例（38％）复发性房颤/房性心动过速。房颤病史的持续时间是首次房颤消融后房颤/房性心动过速复发的唯一预测因素（P = 0.024; OR 1.023，CI 1.003–1.044）。左心房容积正常和阵发性AF史≤48个月相结合，可获得最佳结果。多普勒导出的心房传导时间参数的预测值可能在左心房重构的早期阶段降低。未来的研究可能会确定哪种超声心动图参数与左心房重构程度最相关，并且最能预测成功的房颤消融。

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