CHANGES IN THE FUNCTION OF THE RIGHT AND LEFT ATRIUM IN PATIENTS WITH ATRIAL FIBRILLATION AFTER RADIOFREQUENCY ABLATION
Authors:   Research Institute of Cardiology - branch of the Federal State Scientific Institution ", Moskovskikh Tatiana Valerievna ,   Tomsk National Research Medical Center of the Russian Academy of Sciences",   , Tomsk Russian Federation, Smorgon Andrey Vladimirovich ,   Research Institute of Cardiology - branch of the Federal State Scientific Institution "Tomsk National Research Medical Center of the Russian Academy of Sciences", Tomsk Russian Federation, Usenkov Stanislav Yurievich ,   Research Institute of Cardiology - branch of the Federal State Scientific Institution "Tomsk National Research Medical Center of the Russian Academy of Sciences", Tomsk Russian Federation, Archakov Evgeny Aleksandrovich ,   Research Institute of Cardiology - branch of the Federal State Scientific Institution "Tomsk National Research Medical Center of the Russian Academy of Sciences", Tomsk Russian Federation, Batalov Roman Efimovich ,   Research Institute of Cardiology - branch of the Federal State Scientific Institution "Tomsk National Research Medical Center of the Russian Academy of Sciences", Tomsk Russian Federation, Popov Sergey Valentinovich ,   Research Institute of Cardiology - branch of the Federal State Scientific Institution "Tomsk National Research Medical Center of the Russian Academy of Sciences", Tomsk Russian Federation
Published: October 2023

Introduction. In patients with atrial fibrillation (AF), an informative indicator for predicting the effectiveness of catheter ablation (CA) is atrial function, assessed using speakle treaking echocardiography (EchoCG). A pronounced effect of CA on atrial function was proven, but the study of the dynamics of deformation of both the left (LA) and right atria (RA) has not been previously carried out, despite the fact that many sources describe a significant contribution of LA to the development and maintenance of arrhythmia. Target. To evaluate the dynamics of changes in the function of the left and right atria in patients with atrial fibrillation after radiofrequency ablation. Materials and methods. The study included 57 patients aged 31 to 72 years (55.4±9.8 years) with paroxysmal (n=40) and persistent (n=17) forms of AF. The main diagnoses were hypertension (n=51), coronary heart disease (n=17) without indications for myocardial revascularization, myocarditis without signs of activity (n=3). All patients underwent RFA. Before RFA, 3 days, 3 months and 12 months after, echocardiography was performed in sinus rhythm with an assessment of LA deformity (reservoir, conduction and pumping) and LA (peak longitudinal deformity, PPD). Results. In patients before RFA, the function of the LA reservoir was 26.0±4.99%, the function of the conductor was 16.4 [12.5;20.0]%, the pumping function was 9.19±3.86%, the peak longitudinal deformation of the LA was 28, 1±5.99%. After RFA, a statistically significant decrease in LA function was noted: reservoir 20.2±4.07% (p<0.001), conduction 12.4 [9.4;16.0]% (p<0.001) and pumping 7.08± 3.37 (p<0.001) and the peak longitudinal deformation of the PP increased by 31.0±6.36% (p<0.001). After 3 months, there was a statistically significant increase in the function of the LA reservoir 26.6±4.29% (p<0.001), the function of the conductor 16.7±4.36% (p<0.001), the pumping function 9.13 [6.50;11 .9] % (p<0.001). The peak longitudinal deformity of the RA was 30.6±6.31, which was statistically significantly higher than before surgery (p=0.011). A year later, the function of the LP reservoir was 25.9±5.16% (p<0.001), the function of the conductor was 16.7±4.52% (p<0.001), the pumping function was 9.21±3.39% (p<0.001 ), which was statistically significantly higher than in the early postoperative period. The peak longitudinal deformation of the RA after one year was statistically significantly higher than before RFA – 33.0±6.25% (p<0.001). Conclusion. Radiofrequency ablation has a significant effect on the function of both atria: there is an inhibition of the reservoir, pumping and pipeline function of the LA and an increase in the longitudinal deformation of the RA in the early postoperative period. Restoration of left atrial deformity is observed 3 months after RFA, and persists after a year. The function of the PP after 3 months does not change significantly, but after a year it increases statistically significantly compared with the preoperative 3-month period.