AIMS: Pulmonary vein antrum isolation (PVAI) is an effective treatment for atrial fibrillation (AF); however, its impact on left atrial (LA) size is unknown. This study evaluates the impact of PVAI on LA size, and whether LA size differs between patients with a successful outcome and patients with AF recurrences. METHODS AND RESULTS: Seventy-nine patients (76% male, mean age 56 ± 8 years) with symptomatic, drug refractory AF (70% paroxysmal, 30% persistent/permanent) underwent radiofrequency PVAI. Ablation lesions were created encircling right and left pulmonary venous ostia in pairs. The endpoint was complete isolation of all pulmonary veins. Magnetic resonance imaging was performed before and 4 months after PVAI and LA volume was measured by manually tracing the LA area. Clinical follow-up was at 1, 3, 6, 12, and 24 months. Rhythm status was determined by history, electrocardiogram, and 48 h Holter monitoring. After a mean follow-up of 12 ± 5 months, 62 patients (78%) were free of AF (72% without antiarrhythmic drugs). In the total group, LA volume decreased from 104 ± 27 mL to 91 ± 25 mL, P < 0.001. Patients with a successful outcome showed a decrease in LA volume of 103 ± 27 mL to 89 ± 24 mL, P < 0.001. Among patients with AF recurrences, LA volume decreased from 105 ± 29 mL to 95 ± 27 mL, P = 0.012. No significant difference was seen between the change in LA volume in both subgroups, P = 0.27. CONCLUSION: Pulmonary vein antrum isolation in patients with AF resulted in a significant decrease of LA size. There was no relation between the decrease in LA size and the recurrence of AF after PVAI.
AIMS: Pulmonary vein antrum isolation (PVAI) is an effective treatment for atrial fibrillation (AF); however, its impact on left atrial (LA) size is unknown. This study evaluates the impact of PVAI on LA size, and whether LA size differs between patients with a successful outcome and patients with AF recurrences. METHODS AND RESULTS: Seventy-nine patients (76% male, mean age 56 ± 8 years) with symptomatic, drug refractory AF (70% paroxysmal, 30% persistent/permanent) underwent radiofrequency PVAI. Ablation lesions were created encircling right and left pulmonary venous ostia in pairs. The endpoint was complete isolation of all pulmonary veins. Magnetic resonance imaging was performed before and 4 months after PVAI and LA volume was measured by manually tracing the LA area. Clinical follow-up was at 1, 3, 6, 12, and 24 months. Rhythm status was determined by history, electrocardiogram, and 48 h Holter monitoring. After a mean follow-up of 12 ± 5 months, 62 patients (78%) were free of AF (72% without antiarrhythmic drugs). In the total group, LA volume decreased from 104 ± 27 mL to 91 ± 25 mL, P < 0.001. Patients with a successful outcome showed a decrease in LA volume of 103 ± 27 mL to 89 ± 24 mL, P < 0.001. Among patients with AF recurrences, LA volume decreased from 105 ± 29 mL to 95 ± 27 mL, P = 0.012. No significant difference was seen between the change in LA volume in both subgroups, P = 0.27. CONCLUSION: Pulmonary vein antrum isolation in patients with AF resulted in a significant decrease of LA size. There was no relation between the decrease in LA size and the recurrence of AF after PVAI.
Authors: Andreas Goette; Jonathan M Kalman; Luis Aguinaga; Joseph Akar; Jose Angel Cabrera; Shih Ann Chen; Sumeet S Chugh; Domenico Corradi; Andre D'Avila; Dobromir Dobrev; Guilherme Fenelon; Mario Gonzalez; Stephane N Hatem; Robert Helm; Gerhard Hindricks; Siew Yen Ho; Brian Hoit; Jose Jalife; Young-Hoon Kim; Gregory Y H Lip; Chang-Sheng Ma; Gregory M Marcus; Katherine Murray; Akihiko Nogami; Prashanthan Sanders; William Uribe; David R Van Wagoner; Stanley Nattel Journal: Heart Rhythm Date: 2016-06-10 Impact factor: 6.343
Authors: Irene E Hof; Evert-Jan Vonken; Birgitta K Velthuis; Fred H Wittkampf; Jeroen F van der Heijden; Kars G Neven; Wil Kassenberg; Mathias Meine; Maarten J Cramer; Richard N Hauer; Peter Loh Journal: J Interv Card Electrophysiol Date: 2013-12-07 Impact factor: 1.900
Authors: Martina Nassif; Sébastien P J Krul; Antoine H G Driessen; Thomas Deneke; Arthur A M Wilde; Jacques M T de Bakker; Joris R de Groot Journal: J Interv Card Electrophysiol Date: 2013-04-16 Impact factor: 1.900
Authors: Gijs E De Maat; Stefano Benussi; Yoran M Hummel; Sebastien Krul; Alberto Pozzoli; Antoine H G Driessen; Massimo A Mariani; Isabelle C Van Gelder; Wim-Jan Van Boven; Joris R de Groot Journal: Biomed Res Int Date: 2015-07-07 Impact factor: 3.411