Prevalence and severity of left atrial edema detected by electron beam tomography early after pulmonary vein ablation
Prevalence and severity of left atrial edema detected by electron beam tomography early after pulmonary vein ablation
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DOI：
10.1016/j.jacc.2006.10.076
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发表时间：
2007-04-03
影响因子：
24
通讯作者：
Murohara, Toyoaki
中科院分区：
文献类型：
--
作者：
Okada, Taro;Yamada, Takumi;Murohara, Toyoaki
目的探讨肺静脉消融术（PV）后左房水肿的发生率、严重程度及其对心功能的影响。背景广泛左房导管消融术治疗阵发性心房颤动（PAF）的疗效优于节段性肺静脉口电隔离术（S-PVI），但广泛左房导管消融术可能引起危及生命的并发症，方法对50例药物难治性PAR患者行S-PVI（S组）和27例药物难治性PAR患者行环肺静脉窦消融（C组），在BV消融前、术后1天或2天、术后1个月行增强电子束断层扫描（Ear），结果S组（47例）和C组（10例）患者在肺静脉消融术后即刻行EBT检查，均发现左房水肿。在肺静脉消融术期间，C组的左心房水肿严重程度、射频应用次数和射频能量输送量均显著高于S组。肺静脉消融术后1个月，在所有患者中，EBT评估显示，这些水肿的变化已经消失，和UCG评估显示没有减少的心功能.Conclusions左房水肿观察到在大部分的患者立即肺静脉消融术后，和左房水肿的严重程度取决于在肺静脉消融术的射频能量的范围和数量。LA水肿很快自然消失，未降低心功能。
Objectives The aim of this study was to investigate the prevalence and severity of left atrial (LA) edema after pulmonary vein (PV) ablation and its effect on the cardiac function.Background Though extensive LA catheter ablation has been demonstrated to be more effective in curing paroxysmal atrial fibrillation (PAF) than segmental ostial pulmonary vein isolation (S-PVI), it might cause life-threatening complications, including congestive heart failure associated with LA edema.Methods Fifty patients underwent S-PVI (Group S) and 27 underwent circumferential PV antrum ablation (Group C) for drugrefractory PAR Enhanced electron beam tomography (Ear) was performed before, I or 2 days after, and I month after the BV ablation, and transthoracic ultrasound cardiography (UCG) was performed I month after the PV ablation in all patients.Results The EBT assessment revealed LA edema immediately after the PV ablation in 47 Group S patients and all Group C patients. The severity of the LA edema, number of radiofrequency applications, and amount of radiofrequency energy delivered during the PV ablation was significantly greater in Group C than in Group S. One month after the PV ablation, in all patients, the EBT assessment revealed that those edematous changes had disappeared, and the UCG assessment showed no reduction in the cardiac function.Conclusions Left atrial edema was observed in a large portion of the patients immediately after the PV ablation, and the severity of the LA edema depended on the extent and amount of the radiofrequency energy delivered in the PV ablation. The LA edema soon disappeared naturally and did not reduce the cardiac function.