The relationship between endocardial voltage and regional volume in electroanatomical remodeled left atria in patients with atrial fibrillation: Comparison of three-dimensional computed tomographic images and voltage mapping

Jae Hyung Park, Hui Nam Pak, Eun Jeoung Choi, Jin Kun Jang, Sook Kyoung Kim, Dong Hoon Choi, Jong Il Choi, Chun Hwang, Young Hoon Kim

Research output: Contribution to journalArticle

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Abstract

LA Remodeling in AF. Background: Long-standing atrial fibrillation (AF) changes left atrial (LA) morphology, and the LA size is related to recurrence after radiofrequency catheter ablation (RFCA). We hypothesize that LA morphology, based on embryological origin, affects the outcome of RFCA. Methods: We analyzed 3D computed tomographic (CT) images of LA in 70 patients with AF (54 males, 55.6 ± 10.5 years old, paroxysmal AF (PAF):persistent AF (PeAF) = 32:38) who underwent RFCA. Each LA image was divided into venous atrium (VA), anterior LA (ALA), LA appendage (LAA), and both antrum. Absolute and relative volumes were calculated, and the lengths of linear ablation sites were measured. Results: (1) In patients with the mean LA voltage ≤ 2.0 mV, LA volume, especially ALA, was larger (P < 0.01) compared to those with LA voltage > 2.0 mV. (2) The total LA volume was significantly larger (P < 0.01) and LAA voltages (P < 0.05) and conduction velocities (P < 0.05) were lower in patients with PeAF than in those with PAF. (3) In patients with recurrence, LA volume was generally larger (P < 0.01) than in those without recurrence. In PAF patients with recurrence, the relative volume of ALA was significantly larger (P < 0.01) than those without recurrence. Conclusions Morphologically remodeled LA has low endocardial voltage, and enlargement of ALA is more significant in electroanatomically remodeled LA. The disproportional enlargement of ALA was observed more often in PAF patients with recurrence after ablation than those without recurrence. (J Cardiovasc Electrophysiol, Vol. 20, pp. 1349-1356, December 2009)

Original languageEnglish
Pages (from-to)1349-1356
Number of pages8
JournalJournal of Cardiovascular Electrophysiology
Volume20
Issue number12
DOIs
Publication statusPublished - 2009 Dec 1

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Heart Atria
Atrial Fibrillation
Recurrence
Catheter Ablation
Atrial Remodeling
Atrial Appendage

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

@article{80d211f09aa44735a1cf633d8b203ad2,
title = "The relationship between endocardial voltage and regional volume in electroanatomical remodeled left atria in patients with atrial fibrillation: Comparison of three-dimensional computed tomographic images and voltage mapping",
abstract = "LA Remodeling in AF. Background: Long-standing atrial fibrillation (AF) changes left atrial (LA) morphology, and the LA size is related to recurrence after radiofrequency catheter ablation (RFCA). We hypothesize that LA morphology, based on embryological origin, affects the outcome of RFCA. Methods: We analyzed 3D computed tomographic (CT) images of LA in 70 patients with AF (54 males, 55.6 ± 10.5 years old, paroxysmal AF (PAF):persistent AF (PeAF) = 32:38) who underwent RFCA. Each LA image was divided into venous atrium (VA), anterior LA (ALA), LA appendage (LAA), and both antrum. Absolute and relative volumes were calculated, and the lengths of linear ablation sites were measured. Results: (1) In patients with the mean LA voltage ≤ 2.0 mV, LA volume, especially ALA, was larger (P < 0.01) compared to those with LA voltage > 2.0 mV. (2) The total LA volume was significantly larger (P < 0.01) and LAA voltages (P < 0.05) and conduction velocities (P < 0.05) were lower in patients with PeAF than in those with PAF. (3) In patients with recurrence, LA volume was generally larger (P < 0.01) than in those without recurrence. In PAF patients with recurrence, the relative volume of ALA was significantly larger (P < 0.01) than those without recurrence. Conclusions Morphologically remodeled LA has low endocardial voltage, and enlargement of ALA is more significant in electroanatomically remodeled LA. The disproportional enlargement of ALA was observed more often in PAF patients with recurrence after ablation than those without recurrence. (J Cardiovasc Electrophysiol, Vol. 20, pp. 1349-1356, December 2009)",
author = "Park, {Jae Hyung} and Pak, {Hui Nam} and Choi, {Eun Jeoung} and Jang, {Jin Kun} and Kim, {Sook Kyoung} and Choi, {Dong Hoon} and Choi, {Jong Il} and Chun Hwang and Kim, {Young Hoon}",
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language = "English",
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The relationship between endocardial voltage and regional volume in electroanatomical remodeled left atria in patients with atrial fibrillation : Comparison of three-dimensional computed tomographic images and voltage mapping. / Park, Jae Hyung; Pak, Hui Nam; Choi, Eun Jeoung; Jang, Jin Kun; Kim, Sook Kyoung; Choi, Dong Hoon; Choi, Jong Il; Hwang, Chun; Kim, Young Hoon.

In: Journal of Cardiovascular Electrophysiology, Vol. 20, No. 12, 01.12.2009, p. 1349-1356.

Research output: Contribution to journalArticle

TY - JOUR

T1 - The relationship between endocardial voltage and regional volume in electroanatomical remodeled left atria in patients with atrial fibrillation

T2 - Comparison of three-dimensional computed tomographic images and voltage mapping

AU - Park, Jae Hyung

AU - Pak, Hui Nam

AU - Choi, Eun Jeoung

AU - Jang, Jin Kun

AU - Kim, Sook Kyoung

AU - Choi, Dong Hoon

AU - Choi, Jong Il

AU - Hwang, Chun

AU - Kim, Young Hoon

PY - 2009/12/1

Y1 - 2009/12/1

N2 - LA Remodeling in AF. Background: Long-standing atrial fibrillation (AF) changes left atrial (LA) morphology, and the LA size is related to recurrence after radiofrequency catheter ablation (RFCA). We hypothesize that LA morphology, based on embryological origin, affects the outcome of RFCA. Methods: We analyzed 3D computed tomographic (CT) images of LA in 70 patients with AF (54 males, 55.6 ± 10.5 years old, paroxysmal AF (PAF):persistent AF (PeAF) = 32:38) who underwent RFCA. Each LA image was divided into venous atrium (VA), anterior LA (ALA), LA appendage (LAA), and both antrum. Absolute and relative volumes were calculated, and the lengths of linear ablation sites were measured. Results: (1) In patients with the mean LA voltage ≤ 2.0 mV, LA volume, especially ALA, was larger (P < 0.01) compared to those with LA voltage > 2.0 mV. (2) The total LA volume was significantly larger (P < 0.01) and LAA voltages (P < 0.05) and conduction velocities (P < 0.05) were lower in patients with PeAF than in those with PAF. (3) In patients with recurrence, LA volume was generally larger (P < 0.01) than in those without recurrence. In PAF patients with recurrence, the relative volume of ALA was significantly larger (P < 0.01) than those without recurrence. Conclusions Morphologically remodeled LA has low endocardial voltage, and enlargement of ALA is more significant in electroanatomically remodeled LA. The disproportional enlargement of ALA was observed more often in PAF patients with recurrence after ablation than those without recurrence. (J Cardiovasc Electrophysiol, Vol. 20, pp. 1349-1356, December 2009)

AB - LA Remodeling in AF. Background: Long-standing atrial fibrillation (AF) changes left atrial (LA) morphology, and the LA size is related to recurrence after radiofrequency catheter ablation (RFCA). We hypothesize that LA morphology, based on embryological origin, affects the outcome of RFCA. Methods: We analyzed 3D computed tomographic (CT) images of LA in 70 patients with AF (54 males, 55.6 ± 10.5 years old, paroxysmal AF (PAF):persistent AF (PeAF) = 32:38) who underwent RFCA. Each LA image was divided into venous atrium (VA), anterior LA (ALA), LA appendage (LAA), and both antrum. Absolute and relative volumes were calculated, and the lengths of linear ablation sites were measured. Results: (1) In patients with the mean LA voltage ≤ 2.0 mV, LA volume, especially ALA, was larger (P < 0.01) compared to those with LA voltage > 2.0 mV. (2) The total LA volume was significantly larger (P < 0.01) and LAA voltages (P < 0.05) and conduction velocities (P < 0.05) were lower in patients with PeAF than in those with PAF. (3) In patients with recurrence, LA volume was generally larger (P < 0.01) than in those without recurrence. In PAF patients with recurrence, the relative volume of ALA was significantly larger (P < 0.01) than those without recurrence. Conclusions Morphologically remodeled LA has low endocardial voltage, and enlargement of ALA is more significant in electroanatomically remodeled LA. The disproportional enlargement of ALA was observed more often in PAF patients with recurrence after ablation than those without recurrence. (J Cardiovasc Electrophysiol, Vol. 20, pp. 1349-1356, December 2009)

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