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Left Atrial Wall Thickness Variability Measured by CT Scans
in Patients Undergoing Pulmonary Vein Isolation
Author(s) -
BEINART ROY,
ABBARA SUHNY,
BLUM ANDREW,
FERENCIK MAROS,
HEIST KEVIN,
RUSKIN JEREMY,
MANSOUR MOUSSA
Publication year - 2011
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1111/j.1540-8167.2011.02100.x
Subject(s) - medicine , pulmonary vein , isolation (microbiology) , cardiology , atrial fibrillation , radiology , catheter ablation , left atrium , microbiology and biotechnology , biology
Left Atrial Wall Thickness Variability Measured by CT Scans. Introduction: Successful catheter ablation of atrial fibrillation (AF) requires the creation of transmural lesions in the left atrium (LA). In addition, cardiac perforation is more likely to occur in areas of thin walls. The LA wall thickness is thus relevant both for procedural efficacy and safety. This study sought to evaluate the regional LA wall thickness in patients with AF.Methods:The LA muscular wall thickness (excluding fat) was measured by 64 slice cardiac computed tomography (CT) in 60 patients with persistent AF prior to catheter ablation procedures. Measurements were performed in all patients at 12 distinct LA locations, including 3 at the roof (right, middle left), 3 at the floor (right, middle, left), 4 at the posterior wall (right, middle, middle‐superior, left), 1 at the left lateral ridge (LLR), and 1 at the mitral isthmus.Results:There was a large range of LA wall thickness (average thickness 1.89 ± 0.48 mm, range 0.5–3.5 mm). In addition, there were significant regional differences in LA wall thickness. In particular, the LA roof was significantly thicker than the posterior wall and floor (P < 0.001), the LLR was significantly thicker than most regions (P < 0.04), and the mitral isthmus was also significantly thicker than the posterior wall (P < 0.001) and floor (P < 0.001).Conclusions:In patients with persistent AF, there is inter‐ and intra‐patient variability in the thickness of the LA muscular wall. In most patients, however, the roof, mitral isthmus, and the ridge between the pulmonary veins and appendage are thicker compared to the posterior wall and floor. (J Cardiovasc Electrophysiol, Vol. pp. 1‐5)