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Dilatation of the Pulmonary Veins in Atrial Fibrillation:
Author(s) -
KNACKSTEDT CHRISTIAN,
VISSER LAURENT,
PLISIENE JURGITA,
ZARSE MARKUS,
WALDMANN MATTHIAS,
MISCHKE KARL,
KOCH KARLCHRISTIAN,
HOFFMANN RAINER,
FRANKE ANDREAS,
HANRATH PETER,
SCHAUERTE PATRICK
Publication year - 2003
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1046/j.1460-9592.2003.t01-1-00196.x
Subject(s) - medicine , ostium , cardiology , atrial fibrillation , sinus rhythm , pulmonary vein
Ectopic beats originating from sleeves of atrial tissue within the pulmonary veins (PVs) can induce and sustain paroxysmal atrial fibrillation (AF). Left atrial stretch and dilatation favors the development of atrial ectopy and AF. Similarly, PV dilatation, if present, might trigger PV ectopy in patients with AF. This study was designed to evaluate whether PV dilatation is present in patients with nonfocal AF and whether the PV diameter correlates to the left atrial diameter (LAD). The diameters of the right superior (RSPV) and left superior PV (LSPV) were measured at the ostium and at a depth of 1 cm in 170 patients (AF, n = 75 ; sinus rhythm [SR], n = 95) using transesophageal echocardiography. The LAD was determined by transthoracic echocardiography. The diameters of the PVs were significantly larger in patients with AF than in patients with SR (LSPV ostium : AF 13.6 ± 3.5 mm vs SR 10.6 ± 2.7 mm, P < 0.001 ; LSVP 1cm : AF 12.5 ± 2.9 mm vs SR 10.2 ± 2.5 mm, P < 0.001 ; RSPV ostium , AF 13.9 ± 3.5 mm vs SR 11.7 ± 2.9 mm, P < 0.001 ; RSVP 1cm : AF 12.8 ± 2.8 mm vs SR 10.6 ± 2.6 mm, P < 0.05). Similarly, LAD was larger in patients with AF (44.7 ± 7.7 mm) as compared to patients with SR (38.8 ± 6.8 mm, P < 0.001). Neither for the SR nor the AF group did the PV size correlate to the LAD. AF is associated with a significant enlargement of the RSPV, LSPV, and LAD. There is no correlation between LAD and PV diameters. This raises the question whether PV dilatation in patients with AF is a cause or a consequence of AF and whether it may contribute to the development and perpetuation of AF. (PACE 2003; 26:1371–1378)