Effect And Significance Of Complex Fractionated Atrial Electmgrams Ablation For Atrial Fibrillation On Left Atrial Structure And Function

【objective】The purpose of this study is comparison of circumferential pulmonary veinablation (CPVA) in the treatment of paroxysmal atrial fibrillation,and CPVA based on increasewith Complex fractionated atrial electrograms (CFAEs) ablation for persistence atrialfibrillation on left atrial structure and function changes before and after ablation,the evaluationof CFAEs for persistent atrial fibrillation on left atrial mechanical function,and to explore theCFAEs on left atrium of patients with atrial fibrillation and its clinical value.【Methods】We enrolled of32AF patients Xiamen heart center for the first time RFCA,17patients with paroxysmal AF,15patients with persistent AF. PAF group do onlyCPVA,persistence atrial fibrillation using CPVA addition CFAEs ablation. Applicationtransthoracic echocardiography preoperative and postoperative were1day,3months after sinusrhythm the resting state when key levels room diameter (LAD),left room maximum volume(LAVmax), P wave volume (LAVp), minimum volume (LAVmin). According to thedetermination of the left atrial olume index calculation left atrial passive emptying volume(LApEV=LAVmax-LAVp) and passive emptying scores (LApEF=LApEV/LAVmax); Leftatrial active emptying volume (LAAEV=LAVp-LAVmin) and active emptying scores (namelythe left room ejection fraction LAAEF=LAAEV/LAVp),left room always empty volume(LATEV=LAVmax-LAVmin) and total emptying scores (LATEF=LATEV/LAVmax).Determination of A wave speed peak value (VA)、 A wave speed time integral (A-VTI)andMitral valve opening area of the largest calculation left atrial ejection force (LAEF).【Results】CPVA group,compared with preablation,LAD,LAVmax and LAVmin1dayafter ablation no statistical difference. but the LA pump function,such as VA、V-VTI、LAAEV、LATEF、LAAEF、LAEF decreased significantly than preablation; compared with1day afterablation，LAD reduce，the pump function of the left atrium has no significant changes3monthsafter ablation; persistent atrial fibrillation3months after ablation, compared with1day after ablation, LAD was reduced,LA pump function was decreased. CPVA group compared withCPVA combine CFAEs group no significant difference.【Conclusion】1.CPVA for paroxysmal atrial fibrillation have high success rate andadverse effects as the postoperative left atrial structure, left atrium structure can happen reverseremodeling in recent.2. CPVA for paroxysmal atrial fibrillation on left atrial function decreased, so CPVA haveadverse impact on the left atrial function.3.CPVA addition CFAEs ablation treatment of persistent atrial fibrillation the success rate isrelatively high, LAD was reduced after ablation, LA structure appear reverse remodeling.Postoperative recently LA mechanical function can appear to improve.4. CPVA addition CFAEs ablation for persistent atrial fibrillation can cause left atrial structuralreverse remodeling, and compared with pure with CPVA treatment paroxysmal AF, it is notincrease chipped on the potential of the burden of the left atrium.5. CPVA addition CFAEs ablation for persistent AF is the ideal ablation therapy at present.