Left atrial function after epicardial pulmonary vein isolation in patients with atrial fibrillation

Autor: Stefan Lönnerholm, Per Blomström, L Bagge, Lena Jidéus, Carina Blomström-Lundqvist
Rok vydání: 2017
Předmět:
Male
medicine.medical_specialty
Time Factors
left atrial function
epicardial
atrial fibrillation
left atrial size
minimally invasive
pulmonary vein isolation
vagal denervation
ganglionated plexi
Isolation (health care)
macromolecular substances
030204 cardiovascular system & hematology
Severity of Illness Index
Article
Pulmonary vein
Cohort Studies
Electrocardiography
03 medical and health sciences
0302 clinical medicine
Left atrial
Physiology (medical)
Internal medicine
Humans
Medicine
Cardiac and Cardiovascular Systems
In patient
cardiovascular diseases
030212 general & internal medicine
Aged
Monitoring
Physiologic
Retrospective Studies
Kardiologi
business.industry
Atrial function
P wave
Surgical ablation
Atrial fibrillation
Middle Aged
medicine.disease
Echocardiography
Doppler
Treatment Outcome
Pulmonary Veins
Catheter Ablation
cardiovascular system
Cardiology
Atrial Function
Left
Female
Cardiology and Cardiovascular Medicine
business
Follow-Up Studies
Zdroj: Journal of Interventional Cardiac Electrophysiology
ISSN: 1572-8595
1383-875X
DOI: 10.1007/s10840-017-0290-2
Popis: Purpose Epicardial pulmonary vein isolation has become an increasingly used therapy for medically resistant atrial fibrillation. The purpose of the present study was therefore to evaluate if epicardial pulmonary vein isolation combined with ganglionated plexi ablation affects the size and mechanical function of the left atrium, and whether the effects are dependent on the extensiveness of the ablation applications. Methods A total of 42 patients underwent an echocardiographic examination prior to and 6 months after a minimal invasive epicardial pulmonary vein isolation procedure for the assessment of the effects on left atrial size and function. In 27 patients, who had sinus rhythm both at baseline and follow-up, was a comparison of atrial size and function possible at these time intervals. Fractional area changes were obtained from the left atrial end-systolic and end-diastolic areas in the apical four-chamber view. Pulsed-Doppler was used to assess the transmitral flow velocities to evaluate mechanical function. Results Left atrial size and function at 6-month follow-up had not changed significantly from those at baseline as indicated by left atrial maximal area (17.1 ± 4.6 vs. 18.7 ± 5.3, p = 0.118), minimal area (12.5 ± 3.8 vs. 13.4 ± 4.7, p = 0.248), fractional area change (27.4 ± 8.2 vs. 28.7 ± 10.6, p = 0.670), and E/A ratio (1.49 ± 0.47 vs. 1.54 ± 0.67, p = 0.855). Conclusions Radiofrequency ablation for epicardial pulmonary vein isolation combined with ganglionated plexi ablation has no major effects on atrial function or size. A preserved atrial function for those maintaining sinus rhythm may have important implications for thromboembolic risk after surgery, but warrants confirmation in larger trials.
Databáze: OpenAIRE
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