INTRODUCTION: Restoration of normal sinus rhythm by radiofrequency ablation (RFA) in atrial fibrillation (AF) patients can result in a reduction of left atrial (LA) volume and pulmonary vein (PV) dimensions. It is not clear if this PV size reduction represents a secondary effect of overall LA volume reduction or true PV stenosis. We assessed the relationship between LA volume reduction and PV orifice area pre- and post-RFA. METHODS: A retrospective cohort study was conducted at a tertiary care academic hospital. Pre- and post-RFA cardiac computed tomography (CT) studies of 100 consecutive AF patients were reviewed. Studies identifying obvious segmental PV narrowing were excluded. Left atrial volumes and PV orifice cross-sectional areas (PVOCA) were measured using proprietary software from the CT scanner vendor (GE Healthcare, Waukesha, WI). RESULTS: The cohort had a mean age of 60 ± 8 years, 73% were male, and 90% were Caucasian. Non-paroxysmal AF was present in 76% of patients with a mean duration from diagnosis to RFA of 55 ± 54 months. Mean procedural time was 244 ± 70 min. AF recurred in 27% at 3 month follow-up. Pre-RFA LA volumes were 132 ± 60 ml and mean PVOCA was 2.89 ± 2.32 cm2. In patients with successful ablation, mean LA volume decreased by 10% and PVOCA decreased by 21%. PVOCA was significantly reduced in patients with successful RFA compared to those who had recurrence (2.18 ± 1.12 vs. 2.8 ± 1.9 cm2, p = 0.04) but reduction in LA volume between groups was not significant (118 ± 42 vs. 133 ± 54 ml, p=0.15). CONCLUSIONS: The study demonstrates that both PV orifice dimensions and LA volume are reduced after successful AF ablation. These data warrant a reassessment of criteria for diagnosing PV stenosis based on changes in PV caliber alone, ideally incorporating LA volume changes.
INTRODUCTION: Restoration of normal sinus rhythm by radiofrequency ablation (RFA) in atrial fibrillation (AF) patients can result in a reduction of left atrial (LA) volume and pulmonary vein (PV) dimensions. It is not clear if this PV size reduction represents a secondary effect of overall LA volume reduction or true PV stenosis. We assessed the relationship between LA volume reduction and PV orifice area pre- and post-RFA. METHODS: A retrospective cohort study was conducted at a tertiary care academic hospital. Pre- and post-RFA cardiac computed tomography (CT) studies of 100 consecutive AF patients were reviewed. Studies identifying obvious segmental PV narrowing were excluded. Left atrial volumes and PV orifice cross-sectional areas (PVOCA) were measured using proprietary software from the CT scanner vendor (GE Healthcare, Waukesha, WI). RESULTS: The cohort had a mean age of 60 ± 8 years, 73% were male, and 90% were Caucasian. Non-paroxysmal AF was present in 76% of patients with a mean duration from diagnosis to RFA of 55 ± 54 months. Mean procedural time was 244 ± 70 min. AF recurred in 27% at 3 month follow-up. Pre-RFA LA volumes were 132 ± 60 ml and mean PVOCA was 2.89 ± 2.32 cm2. In patients with successful ablation, mean LA volume decreased by 10% and PVOCA decreased by 21%. PVOCA was significantly reduced in patients with successful RFA compared to those who had recurrence (2.18 ± 1.12 vs. 2.8 ± 1.9 cm2, p = 0.04) but reduction in LA volume between groups was not significant (118 ± 42 vs. 133 ± 54 ml, p=0.15). CONCLUSIONS: The study demonstrates that both PV orifice dimensions and LA volume are reduced after successful AF ablation. These data warrant a reassessment of criteria for diagnosing PV stenosis based on changes in PV caliber alone, ideally incorporating LA volume changes.
Authors: C Pappone; G Oreto; S Rosanio; G Vicedomini; M Tocchi; F Gugliotta; A Salvati; C Dicandia; M P Calabrò; P Mazzone; E Ficarra; C Di Gioia; S Gulletta; S Nardi; V Santinelli; S Benussi; O Alfieri Journal: Circulation Date: 2001-11-20 Impact factor: 29.690
Authors: Atul Verma; Fethi Kilicaslan; James R Adams; Steven Hao; Salwa Beheiry; Stephen Minor; Volkan Ozduran; Samy Claude Elayi; David O Martin; Robert A Schweikert; Walid Saliba; James D Thomas; Mario Garcia; Allan Klein; Andrea Natale Journal: J Cardiovasc Electrophysiol Date: 2006-07
Authors: Alexander Berkowitsch; Thomas Neumann; Okan Ekinci; Harald Greiss; Thorsten Dill; Klaus Kurzidim; Malte Kuniss; Hans J Schneider; Heinz F Pitschner Journal: Pacing Clin Electrophysiol Date: 2005-01 Impact factor: 1.976
Authors: Douglas L Packer; Paul Keelan; Thomas M Munger; Jerome F Breen; Sam Asirvatham; Laura A Peterson; Kristi H Monahan; Mary F Hauser; K Chandrasekaran; Lawrence J Sinak; David R Holmes Journal: Circulation Date: 2005-02-08 Impact factor: 29.690
Authors: Eduardo B Saad; Nassir F Marrouche; Cynthia P Saad; Edward Ha; Dianna Bash; Richard D White; John Rhodes; Lourdes Prieto; David O Martin; Walid I Saliba; Robert A Schweikert; Andrea Natale Journal: Ann Intern Med Date: 2003-04-15 Impact factor: 25.391
Authors: Ana Clara Tude Rodrigues; Mauricio I Scannavacca; Márcia Azevedo Caldas; Viviane Tiemi Hotta; Cristiano Pisani; Eduardo A Sosa; Wilson Mathias Journal: Am J Cardiol Date: 2008-11-21 Impact factor: 2.778
Authors: Melinda Boussoussou; Bálint Szilveszter; Borbála Vattay; Márton Kolossváry; Milán Vecsey-Nagy; Zoltán Salló; Gábor Orbán; Perge Péter; Piros Katalin; Nagy Klaudia Vivien; Osztheimer István; Pál Maurovich-Horvat; Béla Merkely; László Gellér; Nándor Szegedi Journal: Int J Cardiovasc Imaging Date: 2022-02-09 Impact factor: 2.357
Authors: Maryam E Rettmann; David R Holmes; Kristi H Monahan; Jerome F Breen; Tristram D Bahnson; Daniel B Mark; Jeanne E Poole; Alicia M Ellis; Adam P Silverstein; Hussein R Al-Khalidi; Kerry L Lee; Richard A Robb; Douglas L Packer Journal: Circ Arrhythm Electrophysiol Date: 2021-04-13