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A Thin Left Atrial Antral Wall Around the Pulmonary Vein Reflects Structural Remodeling by Atrial Fibrillation and is Associated with Stroke

Title
A Thin Left Atrial Antral Wall Around the Pulmonary Vein Reflects Structural Remodeling by Atrial Fibrillation and is Associated with Stroke
Authors
Park, JunbeomPark, Chul HwanUhm, Jae-SunPak, Hui-NamLee, Moon-HyoungJoung, Boyoung
Ewha Authors
박준범
SCOPUS Author ID
박준범scopus
Issue Date
2017
Journal Title
YONSEI MEDICAL JOURNAL
ISSN
0513-5796JCR Link1976-2437JCR Link
Citation
vol. 58, no. 2, pp. 282 - 289
Keywords
Pulmonary veinwall thicknessablationstrokereconnection
Publisher
YONSEI UNIV COLL MEDICINE
Indexed
SCI; SCIE; SCOPUS; KCI WOS scopus
Abstract
Purpose: Circumferential pulmonary (PV) vein isolation (CPVI) is the most important treatment strategy for atrial fibrillation (AF). While understanding left atrial wall thickness around PVs (PVWT) prior to catheter ablation is important, its clinical implications are not known. This study aimed to evaluate PVWT characteristics according to underlying disease and to identify associations between PVWT and reconnections of PV potentials (PVPs) in redo ablation. Materials and Methods: In 28 patients who underwent redo-AF ablation, PVWT and reconnected PVPs were evaluated at 12 sites (1-12 o'clock) around each PV. Clinical characteristics including stroke and CHA(2)DS(2)-VASc scores were analyzed according to the PVWT. Results: The PVWT was thicker in males than females (p<0.001) and in those with diabetes (p=0.045) or heart failure (p=0.002) than in those without. Patients with strokes or high CHA2DS2-VASc scores (>= 3) had significantly thinner PVWTs than those without strokes or low CHA(2)DS(2)-VASc scores (p<0.001). In redo-ablation, reconnected PVPs were detected in 60 (53.6%) of 112 PVs, and the PVs were thicker (p<0.001) and had more reconnected PVs (p=0.009) than right PVs. A PVWT of >0.6 mm predicted PV reconnections with a sensitivity of 76.7% and specificity of 52.2% with an area under the curve of 0.695. Conclusion: Thick PVWs were associated with diabetes and heart failure, and also showed significant inverse correlations with stroke and the CHA(2)DS(2)-VASc score. Thick PVWs were associated with reconnected PVPs after the CPVI, which were related to AF recurrence.
DOI
10.3349/ymj.2017.58.2.282
Appears in Collections:
의과대학 > 의학과 > Journal papers
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