Morphologic characteristics of the left atrial appendage, roof, and septum

Implications for the ablation of atrial fibrillation

Wanwarang Wongcharoen, Hsuan Ming Tsao, Mei Han Wu, Ching Tai Tai, Shih Lin Chang, Yenn Jiang Lin, Li Wei Lo, Yi Jen Chen, Ming Huei Sheu, Cheng Yen Chang, Shih Ann Chen

Research output: Contribution to journalArticle

92 Citations (Scopus)

Abstract

Introduction: The left atrium (LA) ablation in different regions, including LA appendage (LAA), LA roof, and LA septum, has recently been proposed to improve the success rate of treating patients with atrial fibrillation (AF). The purpose of this study was to investigate the anatomy of LAA, LA roof, and LA septum, using computed tomography (CT). Methods and Results: Multidetector CT scan was used to depict the LA in 47 patients with drug-refractory paroxysmal AF (39 males, age = 50 ± 12 years) and 49 control subjects (34 males, age = 54 ± 11 years). The area of LAA orifice, neck, and the length of roof line were greater in AF group than in control subjects. Three types of LAA locations and two types of LAA ridges were observed. Higher incidence of inferior LAA was noted in AF patients. The different morphologies of LA roof were described. Roof pouches were revealed in 15% of AF and 14% of controls. Moreover, we found septal ridge in 32% of AF and 23% of controls. Conclusions: Considerable variations of LAA and LA roof morphologies were demonstrated. Peculiar structures, including roof pouches and septal ridges, were delineated by CT imaging. These findings were important for determining the strategy of AF ablation and avoiding the procedure-related complications.

Original languageEnglish
Pages (from-to)951-956
Number of pages6
JournalJournal of Cardiovascular Electrophysiology
Volume17
Issue number9
DOIs
Publication statusPublished - Sep 2006
Externally publishedYes

Fingerprint

Atrial Septum
Atrial Appendage
Heart Atria
Atrial Fibrillation
Tomography
Multidetector Computed Tomography
Anatomy
Neck

Keywords

  • Appendage
  • Atrial fibrillation
  • Computed tomography
  • Roof
  • Septum

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology

Cite this

Morphologic characteristics of the left atrial appendage, roof, and septum : Implications for the ablation of atrial fibrillation. / Wongcharoen, Wanwarang; Tsao, Hsuan Ming; Wu, Mei Han; Tai, Ching Tai; Chang, Shih Lin; Lin, Yenn Jiang; Lo, Li Wei; Chen, Yi Jen; Sheu, Ming Huei; Chang, Cheng Yen; Chen, Shih Ann.

In: Journal of Cardiovascular Electrophysiology, Vol. 17, No. 9, 09.2006, p. 951-956.

Research output: Contribution to journalArticle

Wongcharoen, Wanwarang ; Tsao, Hsuan Ming ; Wu, Mei Han ; Tai, Ching Tai ; Chang, Shih Lin ; Lin, Yenn Jiang ; Lo, Li Wei ; Chen, Yi Jen ; Sheu, Ming Huei ; Chang, Cheng Yen ; Chen, Shih Ann. / Morphologic characteristics of the left atrial appendage, roof, and septum : Implications for the ablation of atrial fibrillation. In: Journal of Cardiovascular Electrophysiology. 2006 ; Vol. 17, No. 9. pp. 951-956.
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T2 - Implications for the ablation of atrial fibrillation

AU - Wongcharoen, Wanwarang

AU - Tsao, Hsuan Ming

AU - Wu, Mei Han

AU - Tai, Ching Tai

AU - Chang, Shih Lin

AU - Lin, Yenn Jiang

AU - Lo, Li Wei

AU - Chen, Yi Jen

AU - Sheu, Ming Huei

AU - Chang, Cheng Yen

AU - Chen, Shih Ann

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AB - Introduction: The left atrium (LA) ablation in different regions, including LA appendage (LAA), LA roof, and LA septum, has recently been proposed to improve the success rate of treating patients with atrial fibrillation (AF). The purpose of this study was to investigate the anatomy of LAA, LA roof, and LA septum, using computed tomography (CT). Methods and Results: Multidetector CT scan was used to depict the LA in 47 patients with drug-refractory paroxysmal AF (39 males, age = 50 ± 12 years) and 49 control subjects (34 males, age = 54 ± 11 years). The area of LAA orifice, neck, and the length of roof line were greater in AF group than in control subjects. Three types of LAA locations and two types of LAA ridges were observed. Higher incidence of inferior LAA was noted in AF patients. The different morphologies of LA roof were described. Roof pouches were revealed in 15% of AF and 14% of controls. Moreover, we found septal ridge in 32% of AF and 23% of controls. Conclusions: Considerable variations of LAA and LA roof morphologies were demonstrated. Peculiar structures, including roof pouches and septal ridges, were delineated by CT imaging. These findings were important for determining the strategy of AF ablation and avoiding the procedure-related complications.

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