Value of echocardiography in evaluating efficacy of radiofrequency catheter ablation in patients with atrial fibrillation.

Objective: To analyze the cardiac structure and function of patients with recurrent atrial fibrillation (AF) after radiofrequency catheter ablation (RFCA) with echocardiography and to predict the factors affecting recurrence.

Methods: In this retrospective study, 87 patients who received RFCA for AF in the Weihai Municipal Hospital from June 2018 to December 2019 were enrolled. According to the recovery of postoperative sinus rhythm (SR), patients with recovered SR were assigned to the research group (Res group, n=60), while those with AF recurrence were included in the control group (Con group, n=27). The transthoracic echocardiography was adopted to measure the changes of left atrium-related parameters of patients before RFCA and at 6 months after surgery, and the transesophageal three-dimensional echocardiography was adopted for measuring the changes of left atrial appendage (LAA)-related parameters. In addition, multivariate logistic regression was performed to analyze the factors influencing postoperative recurrence of AF.

Results: After 6-month follow up, SR was restored in 60 cases and AF recurred in 27 cases. After surgery, the left atrial anteroposterior diameter (LAAPD), left atrial left and right diameter (LALRD), left atrial up and down diameter (LAUDD), maximum volume of left atrium (LAVmax), minimum volume of left atrium (LAVmin), opening diameter of LAA (LAAOD), maximum volume of LAA (LAAVmax), and minimum volume of LAA (LAAV min) of the Res group decreased, and were lower than those of the Con group. In addition, the left atrial ejection fraction (LAEF), vessel function index and dilatation index of the Res group increased significantly postoperatively, and were higher than those of the Con group. The Res group also showed significantly higher LAA area change percentage [LAAAC (%)] and LAA emptying velocity (LAAEV) than the Con group. Moreover, age, history of hypertension, LAVmax and LAAAC (%) were identified to be the independent risk factors for postoperative recurrence of AF.

Conclusions: Patients with increased left atrial diameter and volume, large LAAOD, and small ejection fraction are more susceptible to AF recurrence, and LAAOD is a predictor of postoperative recurrence of AF.