Risk Factors Of Recurrence And Influence Of Function Of Left Atrium After Circumferential Electrical Isolation Of Pulmonary

Objective:All the cardiopathies that can influnce the atria including atrial dilatation, atrial hyperplasia, fibration, inflammatory infiltration, inflammatory exfiltration and so on, can induce atrial fibrillation. Sympathetic and parasympatheric nervous system exciting, systemic infection, pulmonary disease, pulmonary embolism, hyperthyrea and other metabolic disorders can induce atrial fibrillation. Atrial fibrillation is one of the common arrhythmia. Haissaguerre first found that pulmonary vein was the main trigger place, and proposed "focal source of atrial fibrillation", then catheter ablation was used in the treatment of atrial fibrillation. Great deal clinical information indicates that recrudesced rate and complication rate, for example pulmonary vein stenosis, are higher after single pulmonary vein abalation. Left atrium plays an important role in the occurring and maintaining of AF. Atrial remodeling is accredited by most scholars. Remodeling of left atrium includes structure remodeling, electronic remodeling and contract remodeling. Remodeling changes left atrial substrate properties, and mades vicious cycle,"AF beget A F". Left atrial substrate properties not only maintains, but also triggers place of AF besides pulmonary vein. Improving left atrial substrate properties has been used in most electrophysiology centers. Circumferential electrical isolation of pulmonary can abalate the spring place, and also eliminate maintain of left atrial substrate properties, can realize vagal denervation. Many massive inside and outside clinical informations indicated circumferential electrical isolation of pulmonary were better than others. In view of above-mentioned background, this experiment elucidated risk factor of recrudescence after ablation through retrospective analysis on 17 AF after ablation; initial investigated the influence of left atrial after ablation of 11 paro-AF.On the study of risk factors for recurrence, the success rate after radiofrequency abalation was lower than those of other literature, It may be associated with the lack of the number of cases, furthermore because of the limitation of this study, no recording of the relevant index which could be measured in the abalation maked no application of multi-element stepwise regression analysis, no procuring the independent risk factor of recurrence, this maybe the lack of this research; In addition, on the study of the left atrial function, the lack of the number of cases and the time of follow-up duration may affect the lower of the systolic function after ablation,If we designed large-scale clinical research and long folloe-up,ther may be different results.Method:17 atrial fibrillation sufferers who accepted catheter ablation were cented two groups: recrudesce group and succeed groups. Analysed the connection of 6 clinical indexes (sex, age, course, left ventricular ejection fraction, left atrial diameter, organic heart disease) and recrudescence. 17 sufferers accepted thransesophageal echocardiography before 1-3 days of ablation to deplete atria sinistrum thromb. The patients measured 10 ultrasound indexes(including LAAPD, LASID, MVA, VE, VA, 4V2, LAVmax, LAVp, LAVmin, LVSV ) before circumferential electrical isolation of pulmonary, and after 3 months measured the same 10 ultrasound indexes by transthoracic echocardiography to only 11 succeed in ablation, then analyse influence of function of left atrium after circumferential electrical isolation of pulmonary.Results:1.Following up one to three months,11(64.71%)atrial fibrillation succeed, 6(32.29%)atrial fibrillation recrudesced.Risk factor of recurrence of atrial fibrillation after ablation is the diameter of left atrium.2.After the ablation,LAAPD increassd(P<0.05); VA,LAEF,LAAEVI,LAAEF all descended, VE/VA increassd(P<0.05);LACVI increassd(P<0.05); LAVImax increassd(P<0.05); LAVImin increassd(P<0.05).Conclusions:1.The succeed rate of Circumferential electrical isolation of pulmonary was 64.71%;2.Diameter of left atrium is the clinical risk factor of recurrence.3. Systonic function of left atrium descended in the near future Passageway function and save function risered in the near future after ablation.4.The patients after ablation of AF should take anticoagulation medicament at least three months..