Effect of minimally invasive surgery on left atrial function in atrial fibrillation patients

doi:10.3969/j.issn.1006-7795.2015.03.007

Abstract

Abstract:

Objective To compare the left atrial function in paroxysmal atrial fibrillation patients before and after undergoing minimally invasive surgery. Methods Consecutive 52 patients with paroxysmal atrial fibrillation who underwent minimally invasive surgery (pulmonary vein isolation, left atrial appendage excision, ligament of Marshall resection) in Anzhen Hospital from October 2012 to June 2014 were enrolled into this study. Left atrial function was measured by real-time three-dimensional echocardiography before operation, 7 days and 3 months after operation. Results 1) Each of the 52 patients successfully underwent the surgery. Neither serious complications related to the operation happened nor embolism events occurred within the 3-month follow-up period. Apart from 6 recurrence, 88.5% (46/52) patients were free of atrial fibrillation. The left atrial appendage of 77% (40/52) patients were successfully excised(left atrial appendage stump <1 cm). 2) Postoperative left atrial maximum volume (LAVmax) was gradually decreased compared to preoperative value (P <0.001), and left atrial minimum volume (LAVmin) detected at postoperative 3 months was decreased as compared with postoperative 7 days and preoperative values respectively (P <0.001). Left atrial emptying fraction (LAEF), as an indicator for storage function, displayed a lower level at postoperative 7 days (P <0.001), but the difference between preoperative and postoperative 3 months was not statistically significant(P=0.235). Left atrial passive ejection fraction (LAPEF) indicating atrial transmission function detected at postoperative 7 days and 3 months both were decreased as compared with preoperative values (P <0.05), but the difference between postoperative 7 days and 3 months was not statistically significant (P=0.052). Left atrial active ejection fraction (LAAEF) indicating atrial pumping function detected at postoperative 3 months was higher than postoperative 7 days and preoperative values. And the value for postoperative 7 days was lower than preoperative value (P <0.05). The peak velocity of A wave detected at postoperative 3 months was higher than that at postoperative 7 days (P <0.05), but the difference between postoperative 3 months and preoperative was not statistically significant (P=0.497). Conclusion 1Minimally invasive surgery can be used as an effective treatment for paroxysmal atrial fibrillation patients to restore sinus rhythm and prevent embolism events. 2We will benefit in strengthening atrial function and reverse remodeling from this operation. Further follow-up studies are warranted to provide a more definite explanation about the effect of minimally invasive surgery on atrial function on our observation.

Key words: atrial fibrillation, atrial function, surgical procedures, minimally invasive

CLC Number:

R541.7

Zhang Zhenhua, Zhang Haibo, Han Jiancheng, Meng Xu, Han Jie, Li Yan, Wang Gang. Effect of minimally invasive surgery on left atrial function in atrial fibrillation patients[J]. Journal of Capital Medical University, 2015, 36(3): 371-375.

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URL: https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/10.3969/j.issn.1006-7795.2015.03.007

https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/Y2015/V36/I3/371

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