Comparison Of Left Atrial Function By Real-Time Three-Dimensional Echocardiography And Speckle Tracking Imaging In Patients Having Catheter Ablation For Atrial Fibrillation

Objective:To evaluate left atrial (LA) function by real-time three-dimensional echocardiography (RT-3D) and speckle tracking imaging (STI) after circumferential ablation of pulmonay vein ostia for atrial fibrillation guided by carto mapping system. Methods:1) The Patients were divided into the group with PAF (n=30) and the group with sinus rhythm (n=30). No Patients with significant dyskinetic cardiac chamber, Systolic dysfunction of LV, valve disease or regional wall motion abnormality were included. Parameters derived from the routine 2D ultrasound, mitral flow pattern, pulmonary vein flow patter, left atrial volume and the strain rate; 2) Thirty patients who had ablation procedure for paroxysmal atrial fibillation were accepted echocardiograpy to estimate the LA function at pre-operation,3 days and 3 months of post-operation. The LA maximal, minimal and pre-systolic volume (LAVmax, LAVmin and LAVp), LA passive ejection fraction (LAPEF), LA active ejection fraction (LAAEF) were measured by RT-3DE respectively. The strain rate curve was acquired in each LA segment (anterior, posterior, lateral, inferior and septal) by STI. Results:1) Compared with the control group, the SRs, SRe and SRa in PAF group decreased in each wall of LA. The SRa of basal, middle, bottom of the posterior were reduced. A significant relation between mLASRa and LAAEF in PAF group; 2) Comparing with preoperative,3 days post-ablation SRs,SRe and SRa decreased significantly in each wall of LA.After 3 months, a significant reduction in LAVmax,LAVpre and LAVmin and a significant improvement in LAPEF and LAAEF. Conclusions 1.STI are readily obtained parameters that provide unique data about atrial function.2.The strain rate of each wall of Left atrial decreased in paroxysmal atrial fibrillation patients, the mutual Compensatory function of the pump function, conduit functions and reservoir function were weakened and disappeared.3.The patients with circumferential pulmonary vein ablation were be in a deterioration after three days. The pump function and conduit functions of left atrial were increased after 3 months.