Evaluation of left atrial structural and function by echocardiography in patients with atrial fibrillation after combined catheter ablation and left atrial appendage closure

doi:10.3877/cma.j.issn.1672-6448.2022.12.004

Abstract

Abstract:

To evaluate left atrial structural and function changes using echocardiography in patients with paroxysmal atrial fibrillation before and after combined catheter ablation and left atrial appendage closure (CA+LAAC) as "one-stop" procedure.

Methods

We selected 26 patients who underwent the "one-stop" procedure at People's hospital of Liaoning province from September 2019 to March 2021 and evaluated their left atrial structural and function changes by echocardiography preoperatively and 3 months after "one-stop" procedure. Left atrial anteroposterior diameter (LAD), left ventricle diameter (LVD), left atrial maximum volume (LAVmax), left atrial minimum volume (LAVmin), left ventricular ejection fraction (LVEF), mitral valve inflow peak spectral velocity in left ventricular early diastole (E-wave), and the average of tissue velocity of mitral annulus on the ventricular septum and tissue velocity of mitral annulus on the lateral wall in left ventricular early diastole (e') were obtained by echocardiography. Left atrial maximum volume index (LAVImax), left atrial minimum volume index (LAVImin), left atrial ejection fraction (LAEF), left atrial expansion index (LAEI), and average E/e' value were calculated by conventional echocardiography. The peak longitudinal strain of the left atrium during reservoir phase (PALSres), the peak longitudinal strain of the left atrium during conduit phase (PALScond), and the peak longitudinal strain of the left atrium during booster pump phase (PALSpump) were measured using two-dimensional speckle tracking imaging (2D-STI) in the apical views of four and two chambers. The changes of left atrial structure and function in patients with paroxysmal atrial fibrillation before and after "one-stop" procedure were compared using the paired t test.

Results

Compared to preoperative values, LAD, LAVmax, LAVmin, LAVImax, and LAVImin significantly decreased at 3 months after the "one-stop" procedure (P＜0.05 for all), while LAEF, LAEI, LVEF, PALSres, PALScond, and PALSpump increased significantly (P＜0.05 for all).

Conclusion

The left atrial structure and function in patients with paroxysmal atrial fibrillation after CA+LAAC recover three months after the "one-stop" procedure. Echocardiography has important clinical value in evaluating the changes of left atrial structure and function in patients with paroxysmal atrial fibrillation.

Key words: Atrial fibrillation, Left atrium, Echocardiography, Two-dimensional speckle tracking imaging, Catheter ablation, Left atrial appendage closure

Yumeng Zheng, Mingyan Ding, Lijuan Guo, Huihui Zhang, LiYing, Hanzhang Zhao, Fang Zhu. Evaluation of left atrial structural and function by echocardiography in patients with atrial fibrillation after combined catheter ablation and left atrial appendage closure[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2022, 19(12): 1336-1341.

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URL: https://chaosheng.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1672-6448.2022.12.004

https://chaosheng.cma-cmc.com.cn/EN/Y2022/V19/I12/1336

Figures/Tables 4

References 23

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参数	术前	术后3个月	P值
LAD（mm）	43.23±5.29	41.73±4.83	0.001
LVD（mm）	45.62±3.48	46.81±3.31	0.061
E（cm/s）	87.46±19.57	79.08±22.79	0.079
EDV（ml）	90.50±11.59	92.69±14.57	0.246
LVEF（%）	53.46±3.63	56.15±2.44	0.001
E/e'	11.16±2.35	10.24±2.34	0.085

参数	术前	术后3个月	P值
LAD（mm）	43.23±5.29	41.73±4.83	0.001
LVD（mm）	45.62±3.48	46.81±3.31	0.061
E（cm/s）	87.46±19.57	79.08±22.79	0.079
EDV（ml）	90.50±11.59	92.69±14.57	0.246
LVEF（%）	53.46±3.63	56.15±2.44	0.001
E/e'	11.16±2.35	10.24±2.34	0.085

参数	术前	术后3个月	P值
LAVmax（ml）	74.09±15.00	68.53±15.39	0.001
LAVmin（ml）	51.98±15.01	45.79±13.00	0.000
LAVImax（ml/m²）	41.14±8.12	38.08±8.33	0.001
LAVImin（ml/m²）	28.95±8.41	25.50±7.38	0.000
LAEF（%）	30.81±8.71	34.08±7.26	0.002
LAEI（%）	46.88±19.45	53.73±17.26	0.002

参数	术前	术后3个月	P值
LAVmax（ml）	74.09±15.00	68.53±15.39	0.001
LAVmin（ml）	51.98±15.01	45.79±13.00	0.000
LAVImax（ml/m²）	41.14±8.12	38.08±8.33	0.001
LAVImin（ml/m²）	28.95±8.41	25.50±7.38	0.000
LAEF（%）	30.81±8.71	34.08±7.26	0.002
LAEI（%）	46.88±19.45	53.73±17.26	0.002

参数	术前	术后3个月	P值
PALSres	14.10±7.43	24.84±5.97	＜0.001
PALScond	7.48±3.80	12.42±3.02	＜0.001
PALSpump	6.69±3.73	12.42±4.21	＜0.001

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