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1. To explore the influence of ablation on right ventricular function in patients with atrial fibrillation (AF).
2. To investigate prognostic values of right ventricular functional parameters in predicting AF recurrence after ablation.
Perspective cohort study. 55 patients with AF were involved. Echocardiography were practiced before, and at 1-3 days, 3-6 months intervals after the radiofrequency ablation surgery. Storing 2D gray scale echocardiography images from 4-chamber view. Using EchoPac software system to generate right and left ventricular time-strain curves. We also visited the involved patients every 6 months, to compare prognoses in AF patients with normal and decreasing right ventricular function.
1. AF patients with early recurrence after the ablation are manifested as significant decreasing tricuspid annular plane systolic excursion (TAPSE), right ventricular global peak longitudinal systolic strain (RV-PLSS-T), right ventricular endocrine peak longitudinal systolic strain (RV-PLSS-ENDO), right ventricular middle-layer peak longitudinal systolic strain (RV-PLSS-MID) and right ventricular epicardial peak longitudinal systolic strain (RV-PLSS-EPI) when comparing with subgroup of no early recurrence (TAPSE 15.9±3.5mm vs. 18.3±4.2mm; RV-PLSS-T 15.9±3.6% vs. 20.0±5.0%, RV-PLSS-ENDO 18.2±4.7% vs. 22.5±6.0%; RV-PLSS-MID 15.9±3.7% vs. 19.7±4.9%; RV-PLSS-EPI 13.5±3.2% vs. 17.7±4.7%; p<0.05 respectively).
2. Early recurrence of AF is significantly positively correlated with course of disease, TAPSE, RV-PLSS-T, RV-PLSS-ENDO, RV-PLSS-MID and RV-PLSS-EPI (OR=1.039, 0.852, 0.813, 0.872, 0.824,0.771, p<0.05, respectively). However, after adjusting in binary logistic model, only the course of disease (OR=1.050) and RV-PLSS-T (OR=0.770) are independent risk factors of early recurrence of AF after ablation (p<0.05 respectively).
3. Right ventricular longitudinal strains are significantly negatively correlated with recurrence of AF: OR=0.802, 0.849, 0.789, 0.796 for RV-PLSS-T, RV-PLSS-ENDO, RV-PLSS-MID and RV-PLSS-EPI; p<0.05 respectively). AF patients with decreasing right longitudinal strains present as shortening event-free survival.
4. After ablation of AF, right ventricular longitudinal systolic function improve quickly and significantly when comparing with baseline (tricuspid annular systolic peak speed 11.9±2.4cm/s vs. 10.6±2.6cm/s, TAPSE 20.1±4.0mm vs. 17.6±4.1mm, RV-PLSS-T 20.5±5.4% vs. 18.7±5.0%, RV-PLSS-ENDO 23.3±5.9% vs. 21.2±6.0%, RV-PLSS-MID 20.4±5.4% vs. 18.5±4.9% and RV-PLSS-EPI 18.2±5.3% vs. 16.4±4.7%,p<0.05 respectively). Obvious differences still persist after 3-6 months of ablation surgery.
1. Radiofrequency ablation surgery could improve right ventricular longitudinal function rapidly, which might be attributed to correction of atrial tachycardia.
2. AF patients with worse right ventricular longitudinal systolic function are more prone to suffer from early recurrence after ablation. Decreasing right ventricular strains might help predict AF recurrence.