心房颤动导管射频消融术逆转功能性三尖瓣反流的超声研究

目的 研究导管射频消融术对非瓣膜病性房颤患者中重度功能性三尖瓣反流的影响及逆转右心重构的作用.方法 采用前瞻性的研究方法,连续入选2010年12月至2012年6月632例非瓣膜病性房颤首次行导管射频消融手术的患者,于手术前（72 h内）进行二维超声心动检查,将伴有中重度功能性三尖瓣反流的患者作为研究对象（12例）,于手术后3个月及6个月复查二维超声心动图,对比分析手术前后超声心动图数据,从而评判导管射频消融术后维持窦性心律对功能性三尖瓣反流的影响及逆转右心重构的作用.结果 导管射频消融术后3个月和6个月右心房上下径[（54.13±6.06）mm比（49.72±5.96）mm,P=0.001;（54.13±6.06）mm比（48.37±5.53）mm,P=0.001]、右心房左右径[（39.29±6.38）mm比（35.09±3.15）mm,P=-0.023;（39.29±6.38）mm比（33.86±2.97）mm,P=0.014]、右心室基底部横径[（34.65±4.51）mm比（32.58±3.93）mm,P=0.033;（34.65±4.51）mm比（31.40±3.59）mm,P=0.043]、三尖瓣反流面积[（7.30±1.37）mm^2比（3.18±2.10）mm^2,P=0.001;（7.30±1.37）mm^2比（1.52±1.92）mm^2,P=0.001]均有所减少,差异有统计学意义.结论 导管射频消融术可以改善非瓣膜病性房颤患者功能性三尖瓣反流的程度,逆转右心重构,疗效确切.

Evidence of atrial functional tricuspid regurgitation due to atrial fibrillation reversal with arrhythmia control

Objective The purpose of this study was to investigate whether non-valvular atrial fibrillation （AF） who had at least moderate functional tricuspid regurgitation （FTR） improve with restoration of sinus rhythm, and whether reconstitution of cor dextrum was reversed. Methods We performed a prospective cohort study. Patients with non-valvular atrial fibrillation underwent first radio frequency catheter ablation at our institution（n=632） were enrolled consecutively from December 2010 to June 2012, who performed two-dimensional echocardiography before surgery （within 72 h）. The group （ n=12 ） had at least moderate TR. The effect of restoration of sinus rhythm was assessed by follow-up echocardiograms at the 3rd month and the 6th month after surgery. Results The echocardiograms at the 3rd month and the 6th month after surgery, such as right atrium vertical diameter, right atrial transverse diameter, right ventricular basal transverse diameter and tricuspid regurgitation area were reduced, and there were statistically significant. Conclusion Atrial fibrillation with functional tricuspid regurgitation may be ameliorated by radio frequency catheter ablation, which may provide a new reference for these patients.