Abstract
Remodeling of PV and LA after AF Ablation. Introduction: Understanding the structural remodeling and reverse remodeling of the left atrium (LA) and pulmonary vein (PV) after radiofrequency ablation of atrial fibrillation (AF) may provide important insights into the mechanism and management of AF. This study used magnetic resonance angiographic (MRA) images to investigate changes in PV and LA morphologies before and more than 1 year after ablation. Method and Results: Forty-five patients (36 men and 9 women, mean age 60 ± 13 years) who underwent MRA before and more than 12 months (mean 21 ± 11) after ablation of paroxysmal AF were included in the study. The patients were divided into two groups: group I included 35 patients without AF recurrence, and group II included 10 patients with late (>1 month postablation) recurrence of AF. The sizes of the LA and nonablated PV were compared before and after ablation. In group I, significant reduction of ostial area of both superior PVs was noted (left superior PV: from 2.85 ± 0.67 to 2.59 ± 0.73 cm2; right superior PV: from 2.89 ± 0.85 to 2.60 ± 0.73 cm2, both P <0.001). Geometric alteration toward a round shape was noted in the ostia of superior PVs during follow-up (eccentricity of right superior PV and left superior PV decreased from 0.31 ± 0.10 to 0.22 ± 0.13 and from 0.27 ± 0.11 to 0.19 ± 0.13, respectively, oth P <0.01). However, LA volume showed only borderline reduction (from 61.52 ± 19.06 to 56.64 ± 17.13 mL, P = 0.05). In group II, significant dilation of the LA (from 61.14 ± 17.54 to 78.73 ± 25.27 mL, P = 0.004) and right superior PV (from 3.41 ± 1.12 to 4.08 ± 1.31 cm2, P = 0.016) was noted during follow-up. Ostial area and eccentricity of the left superior, left inferior, and right inferior PVs and LA were similar before and after ablation. Conclusion: Structural remodeling of the superior PVs and LA can be reversible after successful ablation without AF recurrence; however, late recurrence of AF is associated with progressive LA dilation.
| Original language | English |
|---|---|
| Pages (from-to) | 7-12 |
| Number of pages | 6 |
| Journal | Journal of Cardiovascular Electrophysiology |
| Volume | 16 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - Jan 2005 |
| Externally published | Yes |
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Keywords
- Atrial fibrillation
- Pulmonary vein
- Recurrence
- Remodeling
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- Physiology
Cite this
Morphologic remodeling of pulmonary veins and left atrium after catheter ablation of atrial fibrillation : Insight from long-term follow-up of three-dimensional magnetic resonance imaging. / Tsao, Hsuan Ming; Wu, Mei Han; Huang, Bien Hsien; Lee, Shih Huang; Lee, Kun Tai; Tai, Ching Tai; Lin, Yung Kuo; Hsieh, Ming Hsiung; Kuo, Jen Yuan; Lei, Meng Huan; Chen, Shih Ann.
In: Journal of Cardiovascular Electrophysiology, Vol. 16, No. 1, 01.2005, p. 7-12.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Morphologic remodeling of pulmonary veins and left atrium after catheter ablation of atrial fibrillation
T2 - Insight from long-term follow-up of three-dimensional magnetic resonance imaging
AU - Tsao, Hsuan Ming
AU - Wu, Mei Han
AU - Huang, Bien Hsien
AU - Lee, Shih Huang
AU - Lee, Kun Tai
AU - Tai, Ching Tai
AU - Lin, Yung Kuo
AU - Hsieh, Ming Hsiung
AU - Kuo, Jen Yuan
AU - Lei, Meng Huan
AU - Chen, Shih Ann
PY - 2005/1
Y1 - 2005/1
N2 - Remodeling of PV and LA after AF Ablation. Introduction: Understanding the structural remodeling and reverse remodeling of the left atrium (LA) and pulmonary vein (PV) after radiofrequency ablation of atrial fibrillation (AF) may provide important insights into the mechanism and management of AF. This study used magnetic resonance angiographic (MRA) images to investigate changes in PV and LA morphologies before and more than 1 year after ablation. Method and Results: Forty-five patients (36 men and 9 women, mean age 60 ± 13 years) who underwent MRA before and more than 12 months (mean 21 ± 11) after ablation of paroxysmal AF were included in the study. The patients were divided into two groups: group I included 35 patients without AF recurrence, and group II included 10 patients with late (>1 month postablation) recurrence of AF. The sizes of the LA and nonablated PV were compared before and after ablation. In group I, significant reduction of ostial area of both superior PVs was noted (left superior PV: from 2.85 ± 0.67 to 2.59 ± 0.73 cm2; right superior PV: from 2.89 ± 0.85 to 2.60 ± 0.73 cm2, both P <0.001). Geometric alteration toward a round shape was noted in the ostia of superior PVs during follow-up (eccentricity of right superior PV and left superior PV decreased from 0.31 ± 0.10 to 0.22 ± 0.13 and from 0.27 ± 0.11 to 0.19 ± 0.13, respectively, oth P <0.01). However, LA volume showed only borderline reduction (from 61.52 ± 19.06 to 56.64 ± 17.13 mL, P = 0.05). In group II, significant dilation of the LA (from 61.14 ± 17.54 to 78.73 ± 25.27 mL, P = 0.004) and right superior PV (from 3.41 ± 1.12 to 4.08 ± 1.31 cm2, P = 0.016) was noted during follow-up. Ostial area and eccentricity of the left superior, left inferior, and right inferior PVs and LA were similar before and after ablation. Conclusion: Structural remodeling of the superior PVs and LA can be reversible after successful ablation without AF recurrence; however, late recurrence of AF is associated with progressive LA dilation.
AB - Remodeling of PV and LA after AF Ablation. Introduction: Understanding the structural remodeling and reverse remodeling of the left atrium (LA) and pulmonary vein (PV) after radiofrequency ablation of atrial fibrillation (AF) may provide important insights into the mechanism and management of AF. This study used magnetic resonance angiographic (MRA) images to investigate changes in PV and LA morphologies before and more than 1 year after ablation. Method and Results: Forty-five patients (36 men and 9 women, mean age 60 ± 13 years) who underwent MRA before and more than 12 months (mean 21 ± 11) after ablation of paroxysmal AF were included in the study. The patients were divided into two groups: group I included 35 patients without AF recurrence, and group II included 10 patients with late (>1 month postablation) recurrence of AF. The sizes of the LA and nonablated PV were compared before and after ablation. In group I, significant reduction of ostial area of both superior PVs was noted (left superior PV: from 2.85 ± 0.67 to 2.59 ± 0.73 cm2; right superior PV: from 2.89 ± 0.85 to 2.60 ± 0.73 cm2, both P <0.001). Geometric alteration toward a round shape was noted in the ostia of superior PVs during follow-up (eccentricity of right superior PV and left superior PV decreased from 0.31 ± 0.10 to 0.22 ± 0.13 and from 0.27 ± 0.11 to 0.19 ± 0.13, respectively, oth P <0.01). However, LA volume showed only borderline reduction (from 61.52 ± 19.06 to 56.64 ± 17.13 mL, P = 0.05). In group II, significant dilation of the LA (from 61.14 ± 17.54 to 78.73 ± 25.27 mL, P = 0.004) and right superior PV (from 3.41 ± 1.12 to 4.08 ± 1.31 cm2, P = 0.016) was noted during follow-up. Ostial area and eccentricity of the left superior, left inferior, and right inferior PVs and LA were similar before and after ablation. Conclusion: Structural remodeling of the superior PVs and LA can be reversible after successful ablation without AF recurrence; however, late recurrence of AF is associated with progressive LA dilation.
KW - Atrial fibrillation
KW - Pulmonary vein
KW - Recurrence
KW - Remodeling
UR - http://www.scopus.com/inward/record.url?scp=19944433521&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=19944433521&partnerID=8YFLogxK
U2 - 10.1046/j.1540-8167.2005.04407.x
DO - 10.1046/j.1540-8167.2005.04407.x
M3 - Article
C2 - 15673379
AN - SCOPUS:19944433521
VL - 16
SP - 7
EP - 12
JO - Journal of Cardiovascular Electrophysiology
JF - Journal of Cardiovascular Electrophysiology
SN - 1045-3873
IS - 1
ER -