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- Title
Morphologies of the Atria and Pulmonary Veins in Relation to Lone Atrial Fibrillation Progression: A Dual-Source Computed Tomography Scan Study.
- Authors
LIU, XING‐PENG; XU, XIA; TIAN, YING; TANG, RI‐BO; YU, RONG‐HUI; LONG, DE‐YONG; SANG, CAI‐HUA; JIANG, CHEN‐XI; NING, MAN; DONG, JIAN‐ZENG; MA, CHANG‐SHENG
- Abstract
Atrial Remodeling and Lone Atrial Fibrillation. Background: We sought to investigate the role of anatomic remodeling of the atria and pulmonary veins (PVs) in the progression of lone atrial fibrillation (AF) using dual-source computed tomography (DSCT). Methods and Results: From 1,308 consecutive patients referred for an index ablation procedure for AF, we prospectively enrolled 29 consecutive patients with recently developed (<3 months) lone persistent AF (PsAF) and 23 consecutive patients with short-lasting (6-12 months) lone PsAF, all of whom had a history of paroxysmal AF (PAF). The control group consisted of 33 patients with lone PAF. On DSCT, the recently developed PsAF group showed more extensive atrial anatomic remodeling than the PAF group as shown by ∼40% higher spot biatrial volume, even though the mean duration of continuous AF was only 6 weeks. In contrast, the DSCT variables in the recently developed PsAF group and the short-lasting PsAF group were comparable, despite the fact that the mean duration of continuous AF in the latter group was 8 months. Series of cross-sectional areas of the ostial 1.5 cm of PV trunks were comparable in the PAF and PsAF groups in all but 3 ostial planes. A higher spot left atrial volume was the only independent factor associated with the progression of lone PAF to PsAF (OR: 1.06, 95% CI: 1.03-1.09, P<0.0001) on logistic regression. Conclusions: Prominent anatomic remodeling of the atria, rather than the PVs, underlies the mechanism of recent progression of lone paroxysmal AF to the persistent variety. (J Cardiovasc Electrophysiol, Vol. 23, pp. S29-S35, November 2012)
- Subjects
ANALYSIS of variance; ATRIAL fibrillation; CATHETER ablation; CHI-squared test; FISHER exact test; HEART atrium; LONGITUDINAL method; PULMONARY veins; QUESTIONNAIRES; REGRESSION analysis; STATISTICS; T-test (Statistics); TOMOGRAPHY; LOGISTIC regression analysis; DATA analysis; DISEASE progression; DATA analysis software; DESCRIPTIVE statistics
- Publication
Journal of Cardiovascular Electrophysiology, 2012, Vol 23, ps29
- ISSN
1045-3873
- Publication type
Article
- DOI
10.1111/j.1540-8167.2012.02434.x