Effect of Pulmonary Vein Anatomy and Left Atrial Dimensions on Outcome of Circumferential Radiofrequency Catheter Ablation for Atrial Fibrillation

被引：79
作者：
den Uijl, Dennis W. [1 ]
Tops, Laurens F. [1 ]
Delgado, Victoria [1 ]
Schuijf, Joanne D. [1 ]
Kroft, Lucia J. M. [2 ]
de Roos, Albert [2 ]
Boersma, Eric [3 ]
Trines, Serge A. [1 ]
Zeppenfeld, Katja [1 ]
Schalij, Martin J. [1 ]
Bax, Jeroen J. [1 ]
机构：
[1] Leiden Univ, Med Ctr, Dept Cardiol, Leiden, Netherlands
[2] Leiden Univ, Med Ctr, Dept Radiol, Leiden, Netherlands
[3] Erasmus MC, Dept Cardiol, Rotterdam, Netherlands
来源：
AMERICAN JOURNAL OF CARDIOLOGY | 2011年 / 107卷 / 02期
关键词：
MULTISLICE COMPUTED-TOMOGRAPHY; VENOUS DRAINAGE; VOLUME; ECHOCARDIOGRAPHY; RECOMMENDATIONS; GUIDELINES; PREDICTORS; RECURRENCE; DIAMETER;
D O I：
10.1016/j.amjcard.2010.08.069
中图分类号：
R5 [内科学];
学科分类号：
1002 ; 100201 ;
摘要：
Multislice computed tomography (MSCT) is commonly acquired before radiofrequency catheter ablation (RFCA) for atrial fibrillation (AF) to plan and guide the procedure. MSCT allows accurate measurement of the left atrial (LA) and pulmonary vein (PV) dimensions and classification of the PV anatomy. The aim of the present study was to investigate the effect of LA dimensions, PV dimensions, and PV anatomy on the outcome of circumferential RFCA for AF. A total of 100 consecutive patients undergoing RFCA for AF (paroxysmal 72%, persistent 28%) were studied. The LA dimensions, PV dimensions, and PV anatomy were evaluated three dimensionally using MSCT. The PV anatomy was classified as normal or atypical according to the absence/presence of a common trunk or additional veins. After a mean follow-up of 11.6 +/- 2.8 months, 65 patients (65%) maintained sinus rhythm. The enlargement of the left atrium in the anteroposterior direction on MSCT was related to a greater risk of AF recurrence. No relation was found between the PV dimensions and the outcome of RFCA. In addition, normal right-sided PV anatomy was related to a greater risk of AF recurrence compared to atypical right-sided PV anatomy. Multivariate analysis showed that an anteroposterior LA diameter on MSCT (odds ratio 1.083, p = 0.027) and normal right-sided PV anatomy (odds ratio 6.711, p = 0.006) were independent predictors of AF recurrence after RFCA. In conclusion, enlargement of the anteroposterior LA diameter and the presence of normal anatomy of the right PVs are independent risk factors for AF recurrence. No relation was found between the PV dimensions and outcome of RFCA. (C) 2011 Elsevier Inc. All rights reserved. (Am J Cardiol 2011;107:243-249)
引用
收藏
页码：243 / 249
页数：7
相关论文
共 20 条
[1]   Left atrial volume calculated by multi-detector computed tomography may predict successful pulmonary vein isolation in catheter ablation of atrial fibrillation [J].
Abecasis, Joao ;
Dourado, Raquel ;
Ferreira, Antonio ;
Saraiva, Carla ;
Cavaco, Diogo ;
Santos, Katya Reis ;
Morgado, Francisco Belo ;
Adragao, Pedro ;
Silva, Aniceto .
EUROPACE, 2009, 11 (10) :1289-1294
[2]   Pre-procedural predictors of atrial fibrillation recurrence after circumferential pulmonary vein ablation [J].
Berruezo, Antonio ;
Tamborero, David ;
Mont, Lluis ;
Benito, Begona ;
Tolosana, Jose Maria ;
Sitges, Marta ;
Vidal, Barbara ;
Arriagada, German ;
Mendez, Francisco ;
Matiello, Maria ;
Molina, Irma ;
Brugada, Josep .
EUROPEAN HEART JOURNAL, 2007, 28 (07) :836-841
[3]   HRS/EHRA/ECAS expert consensus statement on catheter and surgical ablation of atrial fibrillation: Recommendations for personnel, policy, procedures and follow-up [J].
Calkins, Hugh ;
Brugada, Josep ;
Packer, Douglas L. ;
Cappato, Riccardo ;
Chen, Shih-Ann ;
Crijns, Harry J. G. ;
Damiano, Ralph J., Jr. ;
Davies, D. Wyn ;
Haines, David E. ;
Haissaguerre, Michel ;
Lesaka, Yoshito ;
Jackman, Warren ;
Jais, Pierre ;
Kottkamp, Hans ;
Kuck, Karl Heinz ;
Lindsay, Bruce D. ;
Marchlinski, Francis E. ;
McCarthy, Patrick M. ;
Mont, J. Lluis ;
Morady, Fred ;
Nademanee, Koonlawee ;
Natale, Andrea ;
Pappone, Carlo ;
Prystowsky, Eric ;
Raviele, Antonio ;
Ruskin, Jeremy N. ;
Shemin, Richard J. .
EUROPACE, 2007, 9 (06) :335-379
[4]   Reliability of MDCT in characterizing pulmonary venous drainage, diameter and distance to first bifurcation: An interobserver study [J].
Cronin, Paul ;
Kelly, Aine Marie ;
Gross, Barry H. ;
Desjardins, Benoit ;
Patel, Smita ;
Kazerooni, Ella A. ;
Carlos, Ruth C. .
ACADEMIC RADIOLOGY, 2007, 14 (04) :437-444
[5]   ACC/AHA/ESC 2006 guidelines for the management of patients with atrial fibrillation:: full text [J].
Fuster, Valentin ;
Ryden, Lars E. ;
Cannom, David S. ;
Crijns, Harry J. ;
Curtis, Anne B. ;
Ellenbogen, Kenneth A. ;
Halperin, Jonathan L. ;
Le Heuzey, Jean-Yves ;
Kay, G. Neal ;
Lowe, James E. ;
Olsson, S. Bertil ;
Prystowsky, Eric N. ;
Tamargo, Juan Luis ;
Wann, Samuel .
EUROPACE, 2006, 8 (09) :651-745
[6]   Spontaneous initiation of atrial fibrillation by ectopic beats originating in the pulmonary veins [J].
Haïssaguerre, M ;
Jaïs, P ;
Shah, DC ;
Takahashi, A ;
Hocini, M ;
Quiniou, G ;
Garrigue, S ;
Le Mouroux, A ;
Le Métayer, P ;
Clémenty, J .
NEW ENGLAND JOURNAL OF MEDICINE, 1998, 339 (10) :659-666
[7]  
Ho SY, 1999, J CARDIOVASC ELECTR, V10, P1525
[8]   Does Left Atrial Volume and Pulmonary Venous Anatomy Predict the Outcome of Catheter Ablation of Atrial Fibrillation? [J].
Hof, Irene ;
Chilukuri, Karuna ;
Arbab-Zadeh, Armin ;
Scherr, Daniel ;
Dalal, Darshan ;
Nazarian, Saman ;
Henrikson, Charles ;
Spragg, David ;
Berger, Ronald ;
Marine, Joseph ;
Calkins, Hugh .
JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, 2009, 20 (09) :1005-1010
[9]   Correlation of Left Atrial Diameter by Echocardiography and Left Atrial Volume by Computed Tomography [J].
Hof, Irene ;
Arbab-Zadeh, Armin ;
Scherr, Daniel ;
Chilukuri, Karuna ;
Dalal, Darshan ;
Abraham, Theodore ;
Lima, Joao ;
Calkins, Hugh .
JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, 2009, 20 (02) :159-163
[10]   Multislice computed tomography versus intracardiac echocardiography to evaluate the pulmonary veins before radiofrequency catheter ablation of atrial fibrillation - A head-to-head comparison [J].
Jongbloed, MRM ;
Bax, JJ ;
Lamb, HJ ;
Dirksen, MS ;
Zeppenfeld, K ;
van der Wan, EE ;
de Roos, A ;
Schalij, MJ .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2005, 45 (03) :343-350
12