Comparison of the atrial electro-mechanical function after successful cardioversion as a result of radiofrequency ablation and drug therapy for paroxysmal atrial fibrillation / 解放军医学杂志

ABSTRACT

Objective To compare the change in atrial electro-mechanical function after successful cardioversion treated by radiofrequency ablation or antiarrhythmic drug therapy in paroxysmal atrial fibrillation (PAF). Methods Sixty patients with PAF and 20 patients with sinus rhythm (control group), admitted or receiving physical examination at the Air Force General Hospital from Jan. 2011 to Jul. 2014, were consecutively enrolled in the present study. Thirty PAF patients were assigned to either the ablation group or drug treatment group according to their own intention. All the subjects received the baseline electrocardiogram and echocardiography, and the same examinations were repeated in all PAF patients in follow up period. P wave duration and amplitude, atrial volume and strain rate were analyzed, and these parameters were compared between the two treatment groups at follow-up. Results No significant difference was detected in baseline parameters of the P wave duration and amplitude, atrial volume, and the strain rate between two PAF groups (P>0.05). However, these parameters were significantly lower than those in control group (P<0.05). Three months after treatment, these atrial parameters were found to be improved, and atrial mechanical parameters including the strain rate was improved obviously (P<0.05). At six-month follow up, atrial parameters of the two PAF groups were further improved. Compared with patients of drug treatment group, the results in patients of ablation group were significantly better (P<0.05). Conclusions The P wave duration and amplitude, atrial volume and strain rate can be used as suitable parameters to evaluate the atrial electro-mechanical function. The atrial conduction and mechanical function of PAF patients can be improved by radiofrequency ablation or by drug therapy. Compared with drug therapy, ablation is more effective in improving the atrial parameters. The improvement of mechanical parameters is earlier than that of electrical conductivity, and it can be used as a sensitive parameter to evaluate atrial function improvement after cardioversion in patients with PAF.