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目的 基于心脏磁共振（CMR）观察脉冲电场消融（PFA）治疗阵发性心房颤动（简称房颤）后患者左心房结构和功能变化。方法 选择拟行PFA治疗的阵发性房颤患者14例，分别于术前0～3 d（术前）、术后0～3 d（术后早期）及术后12个月（术后远期）采用CMR测算患者左心房结构及功能指标，包括左心房最大/最小前后径（LAAD-max/min）、左心房最大/最小横径（LATD-max/min）、左心房最大/最小容积（LAV-max/min）、左心房各肺静脉开口直径（PVOD）、左心房前后运动幅度（LAAP-MA）、左心房横向运动幅度（LATR-MA）及左心房射血分数（LAEF）。结果 14例患者PFA术中均实现双侧肺静脉电隔离，均未发生不良事件。与术前相比，术后早期患者左心房各项结构及功能指标差异均无统计学意义（P均>0.05）；与术前相比，术后远期患者LAAD-min增加、LAAP-MA减少、LAV-max增大（P均<0.05）。结论 PFA治疗阵发性房颤效果较好，术后早期患者左心房结构及功能均无明显变化，术后远期左心房结构变化主要表现为左心房最大容积增加。
Abstract：Objective To observe the changes of left atrial structure and function in patients with paroxysmal atrial fibrillation(AF) after pulsed field ablation(PFA) based on cardiac magnetic resonance(CMR). Methods Fourteen patients with paroxysmal AF scheduled for PFA were enrolled. CMR was performed at three time points: 0-3 days before PFA(pre-operation), 0-3 days after PFA(early post-operation), and 12 months after PFA(long-term post-operation). The measured parameters included: maximum/minimum left atrial anteroposterior diameter(LAAD-max/min), maximum/minimum left atrial transverse diameter(LATD-max/min), maximum/minimum left atrial volume(LAV-max/min), pulmonary vein ostium diameter(PVOD), left atrial anteroposterior motion amplitude(LAAP-MA), left atrial transverse motion amplitude(LATR-MA), and left atrial ejection fraction(LAEF). Results All 14 patients achieved bilateral pulmonary vein isolation during PFA without adverse events. There were no significant differences in left atrial structural or functional parameters between the preoperative and early postoperative assessments(all P>0. 05). At long-term post-operation, LAAD-min increased, LAAP-MA decreased, and LAV-max increased in comparison with those pre-operation(all P<0. 05). Conclusions PFA is effective for paroxysmal AF. No significant changes in left atrial structure or function are observed in the early post-operative period, while during the long-term follow-up, the main structural change in the left atrium is an increase in maximum volume.
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基本信息:
DOI：
中图分类号:R541.75
引用信息:
[1]黎庆捷,杜国相,刘浩,等.基于心脏磁共振的脉冲电场消融治疗阵发性心房颤动后患者左心房结构及功能变化[J].山东医药,2025,65(09):1-5.
基金信息:
广西壮族自治区卫生健康委科研课题项目（Z-A20230637）