| OBJECTIVE:Using CT three-dimensional image technique to observe the morphological changes of circumferential pulmonary vein ablation (CPVA) for atrial fibrillation (AF) on the structure of pulmonary vein before and after radiofrequency ablation.METHODS:28 patients with AF who underwent CPVA were followed-up after (6.5±3.9) months. They were divided into the successful group (22 patients) and the recurrence group (6 patients) according to the recurrence of AF. The results of Pulmonary vein morphology study was compared with analysis of preablation, after following up radiofrequency catheter ablation(6.5±3.9) months. Pulmonary vein diameters, cross-sectional area and left atrial volume were measured before and after CPVA using 64-slice multidector computed tomography (CT).RESULTS:Left lower pulmonary vein maximum diameter, right upper pulmonary vein maximum diameter, right upper pulmonary minimum diameter, right lower pulmonary vein maximum diameter, right lower pulmonary minimum diameter and the four pulmonary vein cross-section areas were significant statistical difference(P<0.05) before and after CPVA, but other maximum diameter, minimum diameter, index and cross-sectional area of pulmonary veins was no significant difference(P>0.05).In the successful group, compared with preablation, Left upper pulmonary vein maximum diameter, right upper pulmonary vein maximum diameter, right upper pulmonary minimum diameter, right lower pulmonary vein maximum diameter, right lower pulmonary minimum diameter, the four pulmonary vein cross-section areas and left atrial volume were significant statistical difference(P<0.05) after CPVA, but left upper pulmonary minimum diameter, left lower pulmonary vein maximum diameter, left lower pulmonary minimum diameter were no significant difference (P>0.05). In the recurrence group, compared with preablation, right lower pulmonary vein maximum diameter, Left lower pulmonary vein cross-section areas and right lower pulmonary vein cross-section areas were significant statistical difference(P<0.05) after CPVA, but other pulmonary minimum indexes and left atrial volume were no significant difference (P>0.05). Stenosis of pulmonary vein maximum diameter and pulmonary minimum diameter less than 50% respectively were 61.6% and 56.3% after CPVA; Stenosis reached 50% and 70% respectively were 3.6% and 5.4%.CONCLUSIONS:1.The Pulmonary vein and left atrial in patients with AF can be reversed its reconstruction after CPVA, but the recurrence group did not significantly reverse remodeling. 2. Some patients have asymptomatic pulmonary vein stenosis after CPVA. |
