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 journalArticlepeer-review

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

Bibliographical note

Funding Information:
This research was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT & Future Planning (NRF-2012R1A2A2A02045367, NRF-2015R1C1A1A02037085), the Ewha Womans University Research Grant (1-2016-0308-001-1) of 2016, and grants from the Korean Healthcare technology R&D project funded by the Ministry of Health & Welfare (HI12C1552, HI16C0058, HI15C1200).

All Science Journal Classification (ASJC) codes

  • Medicine(all)

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