Evaluation Of Patients With Atrial Fibrillation By RT-3DE Combined Strain Imaging Clinical Study Of Left Heart Function Before And After Radiofrequency Ablation

Objective:RT-3DE combined with strain imaging was used to evaluate the changes of left heart structure and function before and after radiofrequency ablation in patients with atrial fibrillation,and to evaluate the myocardial damage before radiofrequency ablation Methods:Seventy patients with paroxysmal atrial fibrillation were randomly selected from the cardiovascular department of our hospital.RT-3DE and strain imaging were used to obtain left cardiac volume and myocardial strain parameters in all patients before and 6 months after admission.The patients were divided into sinus rhythm group(45 cases)and atrial fibrillation recurrence group(25 cases)according to the recurrence of atrial fibrillation after 6 months.In addition,40 healthy control patients with similar age who were examined in our hospital without organic heart disease were selected.In this study,Philip EPIQ 7C ultrasonic diagnostic instrument was used,equipped with S5-1 and X5-1 probes and Qlab 10.5 analysis software.Subjects in the left decubitus position were routinely connected with electrocardiogram and two-dimensional conventional parameters were obtained.The X5-1 probe was switched to obtain the standard apical four-lumen,three-lumen,two-lumen and mitral valve,papillary muscle and apical section.Qlab 10.5 software was used to analyze the left cardiac volume and myocardial strain parameters.According to the case groups and related data types,corresponding statistical methods were selected to analyze the differences among the three groups and explore the independent risk factors for recurrence after radiofrequency ablation.P<0.05 indicated statistically significant difference.Results:Seventy patients with paroxysmal atrial fibrillation were enrolled in this study.The patients were divided into the sinus rhythm group(45 cases)and the atrial fibrillation recurrence group(25 cases)according to the follow-up whether the patients recurred after radiofrequency ablation.There was no statistical significance in the general data of the three groups:gender,age,BMI,BSA,coronary heart disease,hypertension,diabetes,heart rate,etc.(P>0.05);The course of atrial fibrillation was statistically different between the two groups(P<0.05).Compared with the control group,the preoperative LAD,LVEDV,LVESV,LAVImax and LAVImin increased in the sinus rhythm group and the atrial fibrillation recurrence group,while the absolute values of E/A,LVGLS,LVGCS and LAGLS decreased,with statistical significance(P<0.05).There were no significant differences in LVESD,LVEDD and LVEF(P>0.05).LAVImax and LAVImin decreased in the sinus rhythm group compared with the atrial fibrillation recurrence group before surgery,and the difference was statistically significant(P<0.05).There was no significant difference in LAD,LVESD,LVEDD,LVEF,E/A,absolute value of LVGLS,absolute value of LVGCS,LAGLS,LVEDV and LVESV(P>0.05).Compared with the sinus rhythm group before and after surgery,LAD,LVEDV,LVESV,LAVImax and LAVImin decreased,while the absolute value of LVGLS,absolute value of LVGCS and LAGLS increased,with statistical significance(P<0.05).There were no significant differences in E/A,LVESD,LVEDD and LVEF(P>0.05).LVESV,LAVImax and LAVImin increased before and after surgery,while LVGLS absolute value and LAGLS decreased,with statistical significance(P<0.05).There was no significant difference in absolute values of LAD,LVESD,LVEDD,LVEF,E/A,LVGCS and LVEDV(P>0.05).Compared with atrial fibrillation recurrence group,LAD,LVEDV,LVESV,LAVImax and LAVImin decreased after operation,while E/A,absolute value of LVGLS,absolute value of LVGCS and LAGLS increased,with statistical significance(P<0.05).There was no significant difference in LVESD,LVEDD and LVEF(P>0.05).Multivariate logistic regression analysis showed that LAVImax(P=0.035)was an independent risk factor for the recurrence of atrial fibrillation after radiofrequency ablation.Conclusions:By comparing relevant parameters before and after radiofrequency ablation in patients with atrial fibrillation,it was found that the left heart function was decreased in patients before radiofrequency ablation,and the left heart structure and function were significantly improved in the sinus rhythm group 6 months after surgery,indicating that radiofrequency ablation can significantly improve the left heart function in patients.However,the left heart structure and function may be further decreased in the recurrent atrial fibrillation group after radiofrequency ablation,and LAVImax is an independent risk factor for predicting the recurrence of atrial fibrillation after radiofrequency ablation.RT-3DE combined strain imaging can be used to quantitatively evaluate the left ventricular structure and function remodeling before and after radiofrequency ablation of atrial fibrillation,which has a certain value.