Supported by grants from National Science Council (NSC 96-2314-B-010-054), Taiwan.
The Impact of Catheter Ablation on the Dynamic Function of the Left Atrium in Patients with Atrial Fibrillation: Insights from Four-Dimensional Computed Tomographic Images
Article first published online: 5 OCT 2009
© 2009 Wiley Periodicals, Inc.
Journal of Cardiovascular Electrophysiology
Volume 21, Issue 3, pages 270–277, March 2010
How to Cite
TSAO, H.-M., HU, W.-C., WU, M.-H., TAI, C.-T., CHANG, S.-L., LIN, Y.-J., LO, L.-W., HUANG, C.-C., HU, Y.-F., SHEU, M.-H., CHANG, C.-Y. and CHEN, S.-A. (2010), The Impact of Catheter Ablation on the Dynamic Function of the Left Atrium in Patients with Atrial Fibrillation: Insights from Four-Dimensional Computed Tomographic Images. Journal of Cardiovascular Electrophysiology, 21: 270–277. doi: 10.1111/j.1540-8167.2009.01618.x
No conflicts of interest were disclosed.
- Issue published online: 22 FEB 2010
- Article first published online: 5 OCT 2009
- Received 9 June 2009; Revised manuscript received 30 July 2009; Accepted for publication 14 August 2009.
- left atrium (LA);
- multidetector computed tomography (MDCT);
- pulmonary vein;
Functional Evaluation of the LA by Dynamic CT. Introduction: Elucidating the functional properties and remodeling process of the entire left atrium (LA) is important not only for offering the mechanistic insight into atrial fibrillation (AF) but also for assessing the effectiveness of catheter ablation.
Methods: We included 65 patients with paroxysmal AF and 29 controls. Baseline multidetector computed tomography (MDCT) was acquired in all subjects and a follow-up MDCT was available in 48 patients after pulmonary vein and LA ablation. The 3-dimensional images at atrial end-diastole (ED) and end-systole (ES) were analyzed.
Results: The LA volume (ED: 61.11 ± 15.94 vs 54.12 ± 8.94 mL/m2, P = 0.03; ES: 45.29 ± 17.64 vs 33.38 ± 7.78 mL/m2, P < 0.001) was increased, and ejection fraction (EF) (26.93 ± 13.40 vs 38.09 ± 11.62%, P < 0.001) decreased in AF patients as compared to controls. After ablation, the ES LA volume (44.73 ± 14.93 vs 38.04 ± 11.51 mL/m2, P = 0.04) decreased and the LA EF (25.04 ± 13.13 vs 30.82 ± 7.85%, P = 0.03) increased in patients without any AF recurrence. The wall motion (WM) analysis of the 18 segments of LA revealed increased motional magnitudes of entire LA except for the anterior roof. In contrast, the volume, EF, and WM of LA remained similar in patients with recurrence.
Conclusion: Dilated LA with global hypokinesia was noted in AF patients. Improved LA transport function was demonstrated in patients without any recurrence after ablation. However, the anatomic and functional reverse remodeling was not significant in patients with AF recurrence. (J Cardiovasc Electrophysiol, Vol. 21, pp. 270–277, March 2010)