Morphological changes of the left atrial appendage after catheter ablation of atrial fibrillation

Sheng Hsiung Chang, Hsuan Ming Tsao, Mei Han Wu, Ching Tai Tai, Shih Lin Chang, Wanwarang Wongcharoen, Yenn Jiang Lin, Li Wei Lo, Ming Hsiung Hsieh, Ming Huei Sheu, Cheng Yen Chang, Charles Jia Yin Hou, Shih Ann Chen

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Morphological Changes of the Left Atrial Appendage in AF. Introduction: The left atrial appendage (LAA) has been proven to be the most important site of thrombus formation in patients with atrial fibrillation (AF). However, the information regarding the morphometric alteration of the LAA related to the outcome of AF ablation is still lacking. Thus, we evaluated the long-term changes of the LAA morphology in patients undergoing catheter ablation of AF using magnetic resonance angiography (MRA). Methods and Results: Group 1 included 15 controls without any AF history. Group 2 included 40 patients with drug-refractory paroxysmal AF. They were divided into two subgroups: group 2a included 30 patients without AF recurrence after pulmonary vein (PV) ablation. Group 2b included 10 patients with late recurrence of AF. The LAA morphology before and after (20 ± 11 months) ablation was evaluated by three-dimensional MRA. The group 2 patients had a larger baseline LAA size (including the LAA orifice, neck, and length) and less eccentric LAA orifice and neck. After the AF ablation, there was a significant reduction in the LAA size in the group 2a patients, and the morphology of the LAA neck became more eccentric during the follow-up period. In group 2b, the LAA size increased and no significant change in the eccentricity of the orifice and neck could be noted. Conclusions: The morphometric remodeling of the LAA in the AF patients could be reversed after a successful ablation of the AF. Progressive dilation of the LAA was noted in the patients with AF recurrence. These structural changes in the LAA may play a role in reducing the potential risk of cerebrovascular accidents.

Original languageEnglish
Pages (from-to)47-52
Number of pages6
JournalJournal of Cardiovascular Electrophysiology
Volume18
Issue number1
DOIs
Publication statusPublished - Jan 2007
Externally publishedYes

Fingerprint

Atrial Appendage
Catheter Ablation
Atrial Fibrillation
Neck
Magnetic Resonance Angiography
Recurrence
Pulmonary Veins

Keywords

  • Ablation
  • Atrial fibrillation
  • Left atrial appendage

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology

Cite this

Morphological changes of the left atrial appendage after catheter ablation of atrial fibrillation. / Chang, Sheng Hsiung; Tsao, Hsuan Ming; Wu, Mei Han; Tai, Ching Tai; Chang, Shih Lin; Wongcharoen, Wanwarang; Lin, Yenn Jiang; Lo, Li Wei; Hsieh, Ming Hsiung; Sheu, Ming Huei; Chang, Cheng Yen; Hou, Charles Jia Yin; Chen, Shih Ann.

In: Journal of Cardiovascular Electrophysiology, Vol. 18, No. 1, 01.2007, p. 47-52.

Research output: Contribution to journalArticle

Chang, SH, Tsao, HM, Wu, MH, Tai, CT, Chang, SL, Wongcharoen, W, Lin, YJ, Lo, LW, Hsieh, MH, Sheu, MH, Chang, CY, Hou, CJY & Chen, SA 2007, 'Morphological changes of the left atrial appendage after catheter ablation of atrial fibrillation', Journal of Cardiovascular Electrophysiology, vol. 18, no. 1, pp. 47-52. https://doi.org/10.1111/j.1540-8167.2006.00655.x
Chang, Sheng Hsiung ; Tsao, Hsuan Ming ; Wu, Mei Han ; Tai, Ching Tai ; Chang, Shih Lin ; Wongcharoen, Wanwarang ; Lin, Yenn Jiang ; Lo, Li Wei ; Hsieh, Ming Hsiung ; Sheu, Ming Huei ; Chang, Cheng Yen ; Hou, Charles Jia Yin ; Chen, Shih Ann. / Morphological changes of the left atrial appendage after catheter ablation of atrial fibrillation. In: Journal of Cardiovascular Electrophysiology. 2007 ; Vol. 18, No. 1. pp. 47-52.
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abstract = "Morphological Changes of the Left Atrial Appendage in AF. Introduction: The left atrial appendage (LAA) has been proven to be the most important site of thrombus formation in patients with atrial fibrillation (AF). However, the information regarding the morphometric alteration of the LAA related to the outcome of AF ablation is still lacking. Thus, we evaluated the long-term changes of the LAA morphology in patients undergoing catheter ablation of AF using magnetic resonance angiography (MRA). Methods and Results: Group 1 included 15 controls without any AF history. Group 2 included 40 patients with drug-refractory paroxysmal AF. They were divided into two subgroups: group 2a included 30 patients without AF recurrence after pulmonary vein (PV) ablation. Group 2b included 10 patients with late recurrence of AF. The LAA morphology before and after (20 ± 11 months) ablation was evaluated by three-dimensional MRA. The group 2 patients had a larger baseline LAA size (including the LAA orifice, neck, and length) and less eccentric LAA orifice and neck. After the AF ablation, there was a significant reduction in the LAA size in the group 2a patients, and the morphology of the LAA neck became more eccentric during the follow-up period. In group 2b, the LAA size increased and no significant change in the eccentricity of the orifice and neck could be noted. Conclusions: The morphometric remodeling of the LAA in the AF patients could be reversed after a successful ablation of the AF. Progressive dilation of the LAA was noted in the patients with AF recurrence. These structural changes in the LAA may play a role in reducing the potential risk of cerebrovascular accidents.",
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AU - Chang, Sheng Hsiung

AU - Tsao, Hsuan Ming

AU - Wu, Mei Han

AU - Tai, Ching Tai

AU - Chang, Shih Lin

AU - Wongcharoen, Wanwarang

AU - Lin, Yenn Jiang

AU - Lo, Li Wei

AU - Hsieh, Ming Hsiung

AU - Sheu, Ming Huei

AU - Chang, Cheng Yen

AU - Hou, Charles Jia Yin

AU - Chen, Shih Ann

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N2 - Morphological Changes of the Left Atrial Appendage in AF. Introduction: The left atrial appendage (LAA) has been proven to be the most important site of thrombus formation in patients with atrial fibrillation (AF). However, the information regarding the morphometric alteration of the LAA related to the outcome of AF ablation is still lacking. Thus, we evaluated the long-term changes of the LAA morphology in patients undergoing catheter ablation of AF using magnetic resonance angiography (MRA). Methods and Results: Group 1 included 15 controls without any AF history. Group 2 included 40 patients with drug-refractory paroxysmal AF. They were divided into two subgroups: group 2a included 30 patients without AF recurrence after pulmonary vein (PV) ablation. Group 2b included 10 patients with late recurrence of AF. The LAA morphology before and after (20 ± 11 months) ablation was evaluated by three-dimensional MRA. The group 2 patients had a larger baseline LAA size (including the LAA orifice, neck, and length) and less eccentric LAA orifice and neck. After the AF ablation, there was a significant reduction in the LAA size in the group 2a patients, and the morphology of the LAA neck became more eccentric during the follow-up period. In group 2b, the LAA size increased and no significant change in the eccentricity of the orifice and neck could be noted. Conclusions: The morphometric remodeling of the LAA in the AF patients could be reversed after a successful ablation of the AF. Progressive dilation of the LAA was noted in the patients with AF recurrence. These structural changes in the LAA may play a role in reducing the potential risk of cerebrovascular accidents.

AB - Morphological Changes of the Left Atrial Appendage in AF. Introduction: The left atrial appendage (LAA) has been proven to be the most important site of thrombus formation in patients with atrial fibrillation (AF). However, the information regarding the morphometric alteration of the LAA related to the outcome of AF ablation is still lacking. Thus, we evaluated the long-term changes of the LAA morphology in patients undergoing catheter ablation of AF using magnetic resonance angiography (MRA). Methods and Results: Group 1 included 15 controls without any AF history. Group 2 included 40 patients with drug-refractory paroxysmal AF. They were divided into two subgroups: group 2a included 30 patients without AF recurrence after pulmonary vein (PV) ablation. Group 2b included 10 patients with late recurrence of AF. The LAA morphology before and after (20 ± 11 months) ablation was evaluated by three-dimensional MRA. The group 2 patients had a larger baseline LAA size (including the LAA orifice, neck, and length) and less eccentric LAA orifice and neck. After the AF ablation, there was a significant reduction in the LAA size in the group 2a patients, and the morphology of the LAA neck became more eccentric during the follow-up period. In group 2b, the LAA size increased and no significant change in the eccentricity of the orifice and neck could be noted. Conclusions: The morphometric remodeling of the LAA in the AF patients could be reversed after a successful ablation of the AF. Progressive dilation of the LAA was noted in the patients with AF recurrence. These structural changes in the LAA may play a role in reducing the potential risk of cerebrovascular accidents.

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