The role of myocardial wall thickness in atrial arrhythmogenesis

被引：92

作者：

Whitaker, John ^{[1
,2
]}

Rajani, Ronak ^{[3
]}

Chubb, Henry ^{[1
,2
,4
]}

Gabrawi, Mark ^{[1
,2
]}

Varela, Marta ^{[1
,2
]}

Wright, Matthew ^{[1
,2
]}

Niederer, Steven ^{[1
,2
]}

O'Neill, Mark D. ^{[1
,2
]}

机构：

[1] Kings Coll London, St Thomas Hosp, Electrophysiol Div, Cardiovasc Directorate, 4th Floor,North Wing,Westminster Bridge Rd, London SE1 7EH, England

[2] Kings Coll London, St Thomas Hosp, Div Imaging Sci & Biomed Engn, 4th Floor,North Wing,Westminster Bridge Rd, London SE1 7EH, England

[3] Guys & St Thomas NHS Fdn Trust, Dept Cardiac Computed Tomog, Cardiovasc Directorate, London, England

[4] Evelina London Childrens Hosp, Dept Paediat Cardiol, London, England

来源：

EUROPACE | 2016年 / 18卷 / 12期

基金：

英国工程与自然科学研究理事会; 英国医学研究理事会;

关键词：

Left atrial wall thickness; Atrial fibrillation; AF; Cardiac computed tomography; Cardiac CT; PULMONARY VEIN ISOLATION; RADIOFREQUENCY ABLATION LESIONS; INTERATRIAL SEPTAL THICKNESS; CATHETER ABLATION; MAGNETIC-RESONANCE; FIBRILLATION ABLATION; COMPUTED-TOMOGRAPHY; CONDUCTION; ACTIVATION; MECHANISM;

D O I：

10.1093/europace/euw014

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Changes in the structure and electrical behaviour of the left atrium are known to occur with conditions that predispose to atrial fibrillation (AF) and in response to prolonged periods of AF. We review the evidence that changes in myocardial thickness in the left atrium are an important part of this pathological remodelling process. Autopsy studies have demonstrated changes in the thickness of the atrial wall between patients with different clinical histories. Comparison of the reported tissue dimensions from pathological studies provides an indication of normal ranges for atrial wall thickness. Imaging studies, most commonly done using cardiac computed tomography, have demonstrated that these changes may be identified non-invasively. Experimental evidence using isolated tissue preparations, animal models of AF, and computer simulations proves that the three-dimensional tissue structure will be an important determinant of the electrical behaviour of atrial tissue. Accurately identifying the thickness of the atrial may have an important role in the non-invasive assessment of atrial structure. In combination with atrial tissue characterization, a comprehensive assessment of the atrial dimensions may allow prediction of atrial electrophysiological behaviour and in the future, guide radiofrequency delivery in regions based on their tissue thickness.

引用

页码：1758 / 1772

页数：15

共 77 条

[51] ATRIAL FIBRILLATION AS A SELF-SUSTAINING ARRHYTHMIA INDEPENDENT OF FOCAL DISCHARGE [J].