TY - JOUR
T1 - Left atrial wall thickness variability measured by CT scans in patients undergoing pulmonary vein isolation
AU - Beinart, Roy
AU - Abbara, Suhny
AU - Blum, Andrew
AU - Ferencik, Maros
AU - Heist, Kevin
AU - Ruskin, Jeremy
AU - Mansour, Moussa
PY - 2011/11
Y1 - 2011/11
N2 - Left Atrial Wall Thickness Variability Measured by CT Scans. Introduction: Successful catheter ablation of atrial fibrillation (AF) requires the creation of transmural lesions in the left atrium (LA). In addition, cardiac perforation is more likely to occur in areas of thin walls. The LA wall thickness is thus relevant both for procedural efficacy and safety. This study sought to evaluate the regional LA wall thickness in patients with AF. Methods: The LA muscular wall thickness (excluding fat) was measured by 64 slice cardiac computed tomography (CT) in 60 patients with persistent AF prior to catheter ablation procedures. Measurements were performed in all patients at 12 distinct LA locations, including 3 at the roof (right, middle left), 3 at the floor (right, middle, left), 4 at the posterior wall (right, middle, middle-superior, left), 1 at the left lateral ridge (LLR), and 1 at the mitral isthmus. Results: There was a large range of LA wall thickness (average thickness 1.89 ± 0.48 mm, range 0.5-3.5 mm). In addition, there were significant regional differences in LA wall thickness. In particular, the LA roof was significantly thicker than the posterior wall and floor (P < 0.001), the LLR was significantly thicker than most regions (P < 0.04), and the mitral isthmus was also significantly thicker than the posterior wall (P < 0.001) and floor (P < 0.001). Conclusions: In patients with persistent AF, there is inter- and intra-patient variability in the thickness of the LA muscular wall. In most patients, however, the roof, mitral isthmus, and the ridge between the pulmonary veins and appendage are thicker compared to the posterior wall and floor.
AB - Left Atrial Wall Thickness Variability Measured by CT Scans. Introduction: Successful catheter ablation of atrial fibrillation (AF) requires the creation of transmural lesions in the left atrium (LA). In addition, cardiac perforation is more likely to occur in areas of thin walls. The LA wall thickness is thus relevant both for procedural efficacy and safety. This study sought to evaluate the regional LA wall thickness in patients with AF. Methods: The LA muscular wall thickness (excluding fat) was measured by 64 slice cardiac computed tomography (CT) in 60 patients with persistent AF prior to catheter ablation procedures. Measurements were performed in all patients at 12 distinct LA locations, including 3 at the roof (right, middle left), 3 at the floor (right, middle, left), 4 at the posterior wall (right, middle, middle-superior, left), 1 at the left lateral ridge (LLR), and 1 at the mitral isthmus. Results: There was a large range of LA wall thickness (average thickness 1.89 ± 0.48 mm, range 0.5-3.5 mm). In addition, there were significant regional differences in LA wall thickness. In particular, the LA roof was significantly thicker than the posterior wall and floor (P < 0.001), the LLR was significantly thicker than most regions (P < 0.04), and the mitral isthmus was also significantly thicker than the posterior wall (P < 0.001) and floor (P < 0.001). Conclusions: In patients with persistent AF, there is inter- and intra-patient variability in the thickness of the LA muscular wall. In most patients, however, the roof, mitral isthmus, and the ridge between the pulmonary veins and appendage are thicker compared to the posterior wall and floor.
KW - CT scan
KW - atrial fibrillation
KW - catheter ablation
KW - left atrium
KW - pulmonary vein isolation
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U2 - 10.1111/j.1540-8167.2011.02100.x
DO - 10.1111/j.1540-8167.2011.02100.x
M3 - Article
C2 - 21615817
AN - SCOPUS:80053509654
SN - 1045-3873
VL - 22
SP - 1232
EP - 1236
JO - Journal of Cardiovascular Electrophysiology
JF - Journal of Cardiovascular Electrophysiology
IS - 11
ER -