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首页> 外文期刊>The American Journal of Cardiology >Differential recovery of regional atrial contraction after restoration of sinus rhythm after intraoperative linear radiofrequency ablation for atrial fibrillation.
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Differential recovery of regional atrial contraction after restoration of sinus rhythm after intraoperative linear radiofrequency ablation for atrial fibrillation.

机译：术中线性射频消融术治疗房颤后窦性心律恢复后区域性心房收缩的差异性恢复。

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The aim of this study was to quantitate regional atrial contractility in patients with atrial fibrillation (AF) maintained in sinus rhythm after creating lines of block by intraoperative linear radiofrequency ablation for AF. We hypothesized that left atrial regional and global function remains impaired after radiofrequency ablation, despite restoration of sinus rhythm in this cohort. Patients with chronic AF maintained in sinus rhythm > or =6 months after radiofrequency ablation (n = 28) were studied and compared with a chronic AF group who, after standard electrical transthoracic cardioversion, were maintained in sinus rhythm for 6 months (n = 32) and a normal cohort (n = 32). Using color Doppler tissue imaging (CDTI), segmental atrial contraction was measured from annular, mid, and superior locations of the left atrium in both the apical 4- and 2-chamber views and of the right atrium in the apical 4-chamber view. Peak positive strain (SI) and atrial strain rate in early (E-sr) and late diastole (A-sr) were measured from mid and superior segments in both the apical 4- and 2-chamber views of the left atrium. The radiofrequency ablation group had significantly lower CDTI, SI, and A-sr values in all segments compared with both the cardioversion and normal groups. The cardioversion group had lower CDTI velocities than normal subjects. In the radiofrequency ablation group, CDTI velocities, SI, and A-sr values of the inferior and lateral segments were differentially and substantially lower than noted in other segments. In conclusion, patients with chronic AF have significant persistent left atrial dysfunction, despite restoration and maintenance of sinus rhythm. Additive global and regional atrial dysfunction was present in the radiofrequency ablation group suggestive of injury caused by the ablation process. These findings may have implications for selecting the duration of subacute and chronic anticoagulation after anatomic alteration of left atrial endocardium using radiofrequency ablation as a means ofrestoring sinus rhythm in chronic AF.
机译：这项研究的目的是量化在术中通过射频线性射频消融术形成阻塞线后，以窦性心律维持房颤（AF）的患者的区域性心房收缩力。我们假设射频消融后左心房区域和整体功能仍然受损，尽管该队列的窦性心律得以恢复。研究了射频消融后维持窦律心律≥6个月的慢性房颤患者（n = 28），并将其与标准经胸腔电复律后维持窦律心律6个月的慢性房颤患者（n = 32）进行比较）和正常队列（n = 32）。使用彩色多普勒组织成像（CDTI），从心尖4腔和2腔视图的左心房的环形，中部和上方位置以及心尖4腔视图的右心房的环形，中间和上方位置测量节段性心房收缩。在左心房的心尖四腔和二腔视图中，从中段和上段测量了早期（E-sr）和舒张后期（A-sr）的峰值正应变（SI）和心房应变率。与心脏复律组和正常组相比，射频消融组所有节段的CDTI，SI和A-sr值均显着降低。心脏复律组的CDTI速度低于正常受试者。在射频消融组中，下节段和外侧节段的CDTI速度，SI和A-sr值有差异，并且显着低于其他节段。总之，尽管窦性心律得以恢复和维持，但患有慢性房颤的患者仍存在明显的持续性左房功能障碍。射频消融组还存在全球性和局部性心房功能障碍，提示由消融过程引起的损伤。这些发现可能对选择射频消融作为恢复慢性房颤窦性心律的左心内膜解剖改变后的亚急性和慢性抗凝的持续时间有影响。

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