Evaluation Of Left Atrial Appendage And Left Atrial Appendage Ridge Structure And Function In Patients With Paroxysmal Atrial Fibrillation Underwent Circumferential Pulmonary Vein Ablation Using Transesophageal Echocardiography

Objective To evaluate the change of left atrial appendage(LAA) and left atrial appendage ridge(LAA-R) structure and function in patients with paroxysmal atrial fibrillation(PAF) after circumferential pulmonary vein ablation (CPVA) using transesophageal echocardiography(TEE).Methods 43 PAF patients underwent CPVA were included. Transthoracic echocardiography (TTE) and transesophageal echocardiography(TEE) images of 1 week before and 24-48 hours,3 months after CPVA were stored for analysis. A range of left atrial(LA)、LA A and LAA-R structural and functional parameters were measured, including left atrial anteroposterior diameter(LADap), left atrial mediolateral diameter(LADml) and left atrial superior-infra diameter(LADsi) by TTE;left atrial appendage peak emptying velocity(LAA-PEV), left atrial appendage peak filling velocity(LAA-PFV), left atrial appendage ridge width(LAA-RW), left atrial appendage end-diastolic area(LAA-EDA), left atrial appendage end-systole area(LAA-ESA), left atrial appendage ejection fraction(LAA-EF), left atrial appendage spontaneous echo contras(LAA-SEC) by TEE.Results Between 24-48 hours, LAA-EF decreased temporarily; but no statistical differences existed(P>0.05)3 months of follow up, LAA-EF increased significantly(P<0.05).After 24-48 hours、3 months,LAA-PEV、 LAA-PFV increased, but no statistical differences existed(P>0.05). Between 24-48 hours, LAA-RW increased significantly(P<0.05); but no statistical differences existed between before CPVA and 3 months(P>0.05).In 43 cases patients with TEE:Before CPVA, LAA-SEC were found in 3 case (6.98%); Between 24-48 hours, LAA-SEC were found in 5 case (11.63%); 3 months after CPVA, LAA-SEC were found in 1 case (2.33%).Conclusions LAA structure and function were significantly increased after CPVA.CPVA can lead to significant damage to LAA and LAA-R in a short time.TEE is an accurate and effective way to evaluate the change of LAA and LAA-R after CPVA.