Open AccessTopographic variability of the left atrium and pulmonary veins assessed by 3D‐CT predicts the recurrence of atrial fibrillation after catheter ablation
Author(s) -
Kiuchi Kunihiko,
Yoshida Akihiro,
Takei Asumi,
Fukuzawa Koji,
Itoh Mitsuaki,
Imamura Kimitake,
Fujiwara Ryudo,
Suzuki Atsushi,
Nakanishi Tomoyuki,
Yamashita Soichiro,
Hirata Kenichi,
Kanda Gaku,
Okajima Katsunori,
Shimane Akira,
Yamada Shinichiro,
Taniguchi Yasuyo,
Yasaka Yoshinori,
Kawai Hiroya
Publication year - 2015
Publication title -
journal of arrhythmia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.463
H-Index - 21
eISSN - 1883-2148
pISSN - 1880-4276
DOI - 10.1016/j.joa.2015.03.006
Subject(s) - medicine , atrial fibrillation , cardiology , left atrium , catheter ablation , ablation , pulmonary vein , ablation of atrial fibrillation
Background Catheter ablation (CA) is an established therapy for atrial fibrillation (AF). However, the assessment of anatomical information and predictors of AF recurrence remain unclear. We investigated the relationship between anatomical information on the left atrium (LA) and pulmonary veins (PVs) from three‐dimensional computed tomography images and the recurrence of AF after CA. Methods Sixty‐seven consecutive AF patients (mean age: 62±10 years, median AF history: 42 (12; 60) months, mean LA size: 41±7 mm, paroxysmal: 56%) underwent CA and were followed for 19±10 months. The segmented surface areas (antral, posterior, septal, and lateral) and dimensions (between the anterior and posterior walls, the right inferior PV and mitral annulus [MA], the right superior PV and MA, the left superior PV and MA, and the mitral isthmus) of the LA were evaluated three dimensionally using the NavX system. The cross‐sectional areas of the PVs were also evaluated. Results After the follow‐up period, 49 patients (73%) remained free from AF. A multivariate analysis showed that the diameter of the mitral isthmus and cross‐sectional area of the right upper PV were associated with AF recurrence (odds ratio: 1.070, CI: 1.02–1.12, p =0.001; odds ratio: 0.41, CI: 0.21–0.77, p =0.006). Conclusion Enlargement of the mitral isthmus and a smaller right superior PV cross‐sectional area were associated with AF recurrence.