Relation Between Left Atrial Wall Thickness in Patients with Atrial Fibrillation and Intracardiac Electrogram Characteristics and ATP-Provoked Dormant Pulmonary Vein Conduction

Journal of Cardiovascular Electrophysiology
Keiko TakahashiAtsushi Hirayama

Abstract

Atrial remodeling plays a key role in development of the substrate for atrial fibrillation (AF). Whether the wall thicknesses of the left atrium (LA) and pulmonary vein (PV)-LA junction affect remodeling and AF ablation is unknown. We investigated the relationship between wall thicknesses, electrogram characteristics, and adenosine triphosphate (ATP)-provoked dormant PV conduction as they pertain to AF. In 50 patients with AF and 25 patients without AF, wall thicknesses of the LA and PV-LA junction were measured on 320-slice computed tomography images. For the AF patients, NavX-based voltage maps generated during sinus rhythm were obtained, and ATP-provoked dormant PV conduction after PV isolation was evaluated. Walls of the LA and PV-LA junction were significantly thicker in the AF patients than in the control patients (1.83 ± 0.29 mm vs. 1.59 ± 0.28 mm, respectively; P = 0.0010; and 0.88 ± 0.14 mm vs. 0.65 ± 0.11 mm, P<0.0001, respectively). Wall thickness at the PV-LA junction was independently associated with AF (β = 0.40, P = 0.0002). In AF patients, the walls of the PV-LA junction showed stepwise thickening across bipolar voltages indicative of severe (bipolar voltage <33rd percentile) to moderate (33rd-66th percentiles) ...Continue Reading

Associated Clinical Trials

Jan 6, 2020·Antonio Berruezo, MD, PhD

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Citations

May 26, 2016·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Kazuki IsoAtsushi Hirayama
Jun 2, 2016·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·John WhitakerMark D O'Neill
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Apr 23, 2017·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Koichi NagashimaAtsushi Hirayama
Jun 21, 2021·JACC. Cardiovascular Imaging·Christoph BeyerFabian Plank

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