Influence of Left Atrial Contraction on Lone Atrial Fibrillation Recurrence after Minimally Invasive Radiofrequency Ablation_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

ZHAONai-shi ,  MEIJu , WUShu-bin , MANan , LIUHao , BIRui

Department of Cardiothoracic Surgery, Xinhua Hospital, Medical school of Shanghai Jiaotong University, Shanghai 200092, P. R. China;

Corresponding author：

MEIJu, Email: ju_mei63@126.com

Keywords：

Atrial fibrillation; Minimally invasive radiofrequency ablation; Left atrial contraction; Mitral A velocity

DOI：

10.7507/1007-4848.20150054

Video：

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Objective To investigate influence of left atrial contraction on lone atrial fibrillation recurrence after minimally invasive radiofrequency ablation. Methods Clinical data of 57 patients with lone atrial fibrillation underwent minimally invasive radiofrequency ablation in Department of Cardiothoracic Surgery, Xinhua Hospital, Medical School of Shanghai Jiaotong University from September 2010 to December 2011 were retrospectively analyzed. According to the absence of mitral A velocity, patients were divided into Group A (absence of mitral A velocity, 20 patients with their age of 56.32±17.18 years, including 5 females) and Group B (mitral A velocity exists, 37 patients with their age of 60.33±11.22 years, including 17 females). Minimally invasive radiofrequency ablation via thoracoscope were performed in all patients. Preoperative and postoperative left atrial diameter (LAD), left ventricular ejection fraction (LVEF) and mitral A velocity, as well as clinical and follow-up data were recorded and compared. Results Preoperative clinical characters were not statistically different between two groups (P > 0.05). All the patients were followed up for 24.3±8.8 months (range, 12-26 months). Rate of postoperative atrial fibrillation recurrence in group A was significantly higher than that in group B (20.0% vs. 2.7%, P < 0.05). LAD and LVEF of 57 patients at 6 months after surgery were significantly higher than preoperative LAD and LVEF (P < 0.05), but there was no statistic difference between two groups (P > 0.05). Conclusion Damage of left atrial contraction was related to lone atrial fibrillation recurrence after minimally invasive radiofrequency ablation. Absence of mitral A velocity could be a crucial predictor of postoperative lone atrial fibrillation recurrence.

Citation： ZHAONai-shi, MEIJu, WUShu-bin, MANan, LIUHao, BIRui. Influence of Left Atrial Contraction on Lone Atrial Fibrillation Recurrence after Minimally Invasive Radiofrequency Ablation. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2015, 22(3): 187-191. doi: 10.7507/1007-4848.20150054 Copy

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2.	Haïssaguerre M, Jaïs P, Shah DC, et al.Spontaneous initiation of atrial fibrillation by ectopic beats originating in the pulmonary veins.N Engl J Med, 1998, 339(10):659-666.
3.	Angkeow P, Calkins HG.Complications associated with radiofrequency catheter ablation of cardiac arrhythmias.Cardiol Rev, 2001, 9(3):121-130.
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7.	Loghin C, Karimzadehnajar K, Ekeruo IA, et al.Outcome of pulmonary vein isolation ablation for paroxysmal atrial fibrillation:predictive role of left atrial mechanical dyssynchrony by speckle tracking echocardiography.J Interv Card Electrophysiol, 2014, 39(1):7-15.
8.	Fuster V, Rydén LE, Cannom DS, et al.2011 ACCF/AHA/HRS focused updates incorporated into the ACC/AHA/ESC 2006 guidelines for the management of patients with atrial fibrillation:a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines.Circulation, 2011, 123(10):e269-e367.
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10.	Park TH, Nagueh SF, Khoury DS, et al.Impact of myocardial struc-ture and function postinfarction on diastolic strain measurements:implications for assessment of myocardial viability.Am J Physiol Heart Circ Physiol, 2006, 290(2):H724-H731.
11.	Nattel S, Shiroshita-Takeshita A, Brundel BJ, et al.Mechanisms of atrial fibrillation:lessons from animal models.Prog Cardiovasc Dis, 2005, 48(1):9-28.
12.	Morillo CA, Klein GJ, Jones DL, et al.Chronic rapid atrial pacing, structural, functional and electrophysiological characteristics of a new model of sustained atrial fibrillation.Circulation, 1995, 91(5):1588-1595.
13.	Burstein B, Nattel S.Atrial fibrosis:mechanisms and clinical relevance in atrial fibrillation.J Am Coll Cardiol, 2008, 51(8):802-809.
14.	刘玉学, 王欣.心房颤动中心房重构机制的研究进展.中国胸心血管外科临床杂志, 2009, 16(3):218-221.
15.	Vieira MJ, Teixeira R, Gonçalves L, et al.Left atrial mechanics:echocardiographic assessment and clinical implications.J Am Soc Echocardiogr, 2014, 27(5):463-478.
16.	Letsas KP, Weber R, Bürkle G, et al.Pre-ablative predictors of atrial fibrillation recurrence following pulmonary vein isolation:the potential role of inflammation.Europace, 2009, 11(2):158-163.
17.	Pandozi C, Santini M.Update on atrial remodeling owing to rate.Does atrial fibrillation always beget atrial fibrillation? Eur Heart J, 2001, 22(7):541-553.
18.	李菲, 孟旭.术前左心房内径对外科射频术治疗心房颤动疗效的影响.中国胸心血管外科临床杂志, 2013, 20(1):38-42.
19.	Buber J, Luria D, Sternik L, et al.Left atrial contractile function following a successful modified Maze procedure at surgery and the risk for subsequent thromboembolic stroke.J Am Coll Cardiol, 2011, 58(15):1614-1621.
20.	Yashima N, Nasu M, Kawazoe K, et al.Serial evaluation of atrial function by Doppler echocardiography after the maze procedure for chronic atrial fibrillation.Eur Heart J, 1997, 18(3):496-502.

1. Zhou Z, Hu D.An epidemiological study on the prevalence of atrial fibrillation in the Chinese population of mainland China.J Epidemiol, 2008, 18(5):209-216.
2. Haïssaguerre M, Jaïs P, Shah DC, et al.Spontaneous initiation of atrial fibrillation by ectopic beats originating in the pulmonary veins.N Engl J Med, 1998, 339(10):659-666.
3. Angkeow P, Calkins HG.Complications associated with radiofrequency catheter ablation of cardiac arrhythmias.Cardiol Rev, 2001, 9(3):121-130.
4. Mei J, Ma N, Ding F, et al.Complete thoracoscopic ablation of the left atrium via the left chest for treatment of lone atrial fibrillation.J Thorac Cardiovasc Surg, 2014, 147(1):242-246.
5. 马南, 姜兆磊, 陈飞, 等.梅氏微创消融术治疗高龄房颤患者的结果.中国心血管病研究, 2014, 12(10):870-873.
6. 梅举, 马南, 姜兆磊, 等.微创外科治疗孤立性房颤的临床研究(附100例中期结果).中华循环杂志, 2013, z1:175-176.
7. Loghin C, Karimzadehnajar K, Ekeruo IA, et al.Outcome of pulmonary vein isolation ablation for paroxysmal atrial fibrillation:predictive role of left atrial mechanical dyssynchrony by speckle tracking echocardiography.J Interv Card Electrophysiol, 2014, 39(1):7-15.
8. Fuster V, Rydén LE, Cannom DS, et al.2011 ACCF/AHA/HRS focused updates incorporated into the ACC/AHA/ESC 2006 guidelines for the management of patients with atrial fibrillation:a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines.Circulation, 2011, 123(10):e269-e367.
9. Lloyd-Jones D, Adams RJ, Brown TM, et al.American Heart Associa-tion Statistics Committee and Stroke Statistics Subcommittee.Heart disease and stroke statistics--2010 update:a report from the American Heart Association.Circulation, 2010, 121(7):e46-e215.
10. Park TH, Nagueh SF, Khoury DS, et al.Impact of myocardial struc-ture and function postinfarction on diastolic strain measurements:implications for assessment of myocardial viability.Am J Physiol Heart Circ Physiol, 2006, 290(2):H724-H731.
11. Nattel S, Shiroshita-Takeshita A, Brundel BJ, et al.Mechanisms of atrial fibrillation:lessons from animal models.Prog Cardiovasc Dis, 2005, 48(1):9-28.
12. Morillo CA, Klein GJ, Jones DL, et al.Chronic rapid atrial pacing, structural, functional and electrophysiological characteristics of a new model of sustained atrial fibrillation.Circulation, 1995, 91(5):1588-1595.
13. Burstein B, Nattel S.Atrial fibrosis:mechanisms and clinical relevance in atrial fibrillation.J Am Coll Cardiol, 2008, 51(8):802-809.
14. 刘玉学, 王欣.心房颤动中心房重构机制的研究进展.中国胸心血管外科临床杂志, 2009, 16(3):218-221.
15. Vieira MJ, Teixeira R, Gonçalves L, et al.Left atrial mechanics:echocardiographic assessment and clinical implications.J Am Soc Echocardiogr, 2014, 27(5):463-478.
16. Letsas KP, Weber R, Bürkle G, et al.Pre-ablative predictors of atrial fibrillation recurrence following pulmonary vein isolation:the potential role of inflammation.Europace, 2009, 11(2):158-163.
17. Pandozi C, Santini M.Update on atrial remodeling owing to rate.Does atrial fibrillation always beget atrial fibrillation? Eur Heart J, 2001, 22(7):541-553.
18. 李菲, 孟旭.术前左心房内径对外科射频术治疗心房颤动疗效的影响.中国胸心血管外科临床杂志, 2013, 20(1):38-42.
19. Buber J, Luria D, Sternik L, et al.Left atrial contractile function following a successful modified Maze procedure at surgery and the risk for subsequent thromboembolic stroke.J Am Coll Cardiol, 2011, 58(15):1614-1621.
20. Yashima N, Nasu M, Kawazoe K, et al.Serial evaluation of atrial function by Doppler echocardiography after the maze procedure for chronic atrial fibrillation.Eur Heart J, 1997, 18(3):496-502.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Influence of Left Atrial Contraction on Lone Atrial Fibrillation Recurrence after Minimally Invasive Radiofrequency Ablation

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