目的 应用超声心动图观察阵发性心房颤动(PAF)患者射频前后左房结构和收缩功能的变化.方法 52例PAF患者行射频消融术,分别于术前及术后1 d、6个月时应用超声心动图测定左房内径(LAD)、左房面积(LAA)和左房容积(LAV),记录二尖瓣血流频谱A峰流速(VA)、左房射血力(LAF),同时使用组织多普勒记录二尖瓣前瓣环舒张晚期峰值速度(Va).另选30例性别、年龄、体重匹配的窦性心律者为对照组.结果 (1)PAF患者反应左房结构的指标LAD、LAA、LAV较对照组扩大(P<0.05),反应左房收缩功能的指标较VA、LAEF、Va较对照组减低(P<0.05);(2)术后维持窦性心律者(n=45),6个月时左房结构指标较术前均显著改善(P<0.05);(3)维持窦律者术后1 d与术前比较,反应左房收缩功能的指标均减少(P<0.05),术后6个月左房功能恢复到术前水平,差异无统计学意义(P>0.05).结论 阵发性房颤患者射频成功后左房结构重构明显改善,早期左房收缩功能下降,随时间推移左房功能明显恢复.%Objective To evaluate the impact of radiofrequency catheter ablation ( RFCA ) on left atrial ( LA ) structure and function in patients with paroxysmal atrial fibrillation ( PAF ) with the transthoraracic echocardiography.Methods Thansthoracic echocardiography was performed on baseline, and 1 day and 6 months after treatment on 52 patients with radiofrequency ablation treatment for PAF. LA dimension( LAD ), LA area ( LAA ), LA volume ( LAV ), peak velocity of mitral valve inflow ( VA ), LA ejection force ( LAEF ) and peak atrial systolic mitral annulus velocity ( Va )were recorded. Volunteers with sinus rhythm of matched age, gender and weight ( n = 30 ) were enrolled as controls. Results Significant increase of LA structural indicators, including LAD, LAA and LAV, was observed in PAF group, comparing with those of control group ( P＜ 0.05 ); so was the significant reduction of left atrial systolic function indicators, including VA, LAEF and Va ( P＜0.05 ). Patients in PAF group, who kept sinus rhythm after treatment ( n =45 ), presented significant improvement of LA structure, comparing with baseline ( P ＜ 0.05 ). Comparing with baseline, although those kept sinus rhythm after treatment suffered significant reduction of LA systolic function on 1 st day according to respected indicators ( P＜ 0.05 ); no significant loss of LA systolic function in 6th month ( P＞ 0.05 ). Conclusion In patients who maintain sinus rhythm after RFCA, the remodeling and reduced systolic function of the left atrium is reversed.
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