A thin left atrial antral wall around the pulmonary vein reflects structural remodeling by atrial fibrillation and is associated with stroke

Junbeom Park, Chul Hwan Park, Jae Sun Uhm, Hui Nam Pak, Moon Hyoung Lee, Boyoung Joung

Research output: Contribution to journalArticle

2 Citations (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 CHA2DS2-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 CHA2DS2-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 CHA2DS2-VASc score. Thick PVWs were associated with reconnected PVPs after the CPVI, which were related to AF recurrence.

Original languageEnglish
Pages (from-to)282-289
Number of pages8
JournalYonsei medical journal
Volume58
Issue number2
DOIs
Publication statusPublished - 2017 Mar

Fingerprint

Pulmonary Veins
Atrial Fibrillation
Stroke
Catheter Ablation
Area Under Curve
Heart Failure
Recurrence
Sensitivity and Specificity
Antral
Therapeutics

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

@article{9398705b7af74926ade535981853df18,
title = "A thin left atrial antral wall around the pulmonary vein reflects structural remodeling by atrial fibrillation and is associated with stroke",
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 CHA2DS2-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 CHA2DS2-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 CHA2DS2-VASc score. Thick PVWs were associated with reconnected PVPs after the CPVI, which were related to AF recurrence.",
author = "Junbeom Park and Park, {Chul Hwan} and Uhm, {Jae Sun} and Pak, {Hui Nam} and Lee, {Moon Hyoung} and Boyoung Joung",
year = "2017",
month = "3",
doi = "10.3349/ymj.2017.58.2.282",
language = "English",
volume = "58",
pages = "282--289",
journal = "Yonsei Medical Journal",
issn = "0513-5796",
publisher = "Yonsei University College of Medicine",
number = "2",

}

A thin left atrial antral wall around the pulmonary vein reflects structural remodeling by atrial fibrillation and is associated with stroke. / Park, Junbeom; Park, Chul Hwan; Uhm, Jae Sun; Pak, Hui Nam; Lee, Moon Hyoung; Joung, Boyoung.

In: Yonsei medical journal, Vol. 58, No. 2, 03.2017, p. 282-289.

Research output: Contribution to journalArticle

TY - JOUR

T1 - A thin left atrial antral wall around the pulmonary vein reflects structural remodeling by atrial fibrillation and is associated with stroke

AU - Park, Junbeom

AU - Park, Chul Hwan

AU - Uhm, Jae Sun

AU - Pak, Hui Nam

AU - Lee, Moon Hyoung

AU - Joung, Boyoung

PY - 2017/3

Y1 - 2017/3

N2 - 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 CHA2DS2-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 CHA2DS2-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 CHA2DS2-VASc score. Thick PVWs were associated with reconnected PVPs after the CPVI, which were related to AF recurrence.

AB - 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 CHA2DS2-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 CHA2DS2-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 CHA2DS2-VASc score. Thick PVWs were associated with reconnected PVPs after the CPVI, which were related to AF recurrence.

UR - http://www.scopus.com/inward/record.url?scp=85010685944&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85010685944&partnerID=8YFLogxK

U2 - 10.3349/ymj.2017.58.2.282

DO - 10.3349/ymj.2017.58.2.282

M3 - Article

C2 - 28120557

AN - SCOPUS:85010685944

VL - 58

SP - 282

EP - 289

JO - Yonsei Medical Journal

JF - Yonsei Medical Journal

SN - 0513-5796

IS - 2

ER -