title: Dilatation as a marker of pulmonary veins initiating atrial fibrillation.
abstract: BACKGROUND
  The pulmonary veins (PVs) have been shown to trigger paroxysmal atrial fibrillation. The relationship of anatomical dimensions versus arrhythmogenicity has not been assessed.
  
  
  METHODS
  The diameters of four PVs were measured by selective PV angiography before ablation in 39 consecutive patients (23 male, mean age 46 years) with only one (25 patients) or two (14 patients) arrhythmogenic PVs (ArPVs). After ablation of ArPVs, no patient had recurrence of atrial fibrillation from the remaining PVs. Comparisons were performed variously between ArPV and non-ArPV, and within and across both groups.
  
  
  RESULTS
  ArPVs were distributed as follows; left superior PV: 40%, left inferior PV: 28%, right superior PV: 26%, and right inferior PV: 6%. Statistical comparisons showed that (1) Triggers of atrial fibrillation were located in the largest PV in 72% of patients, (2) For each PV, the mean diameter of ArPV was significantly larger than that of non-ArPV (p < 0.05), (3) No significant difference was observed in the diameter of the four different ArPVs (range 16.2 +/- 1.3 to 17.2 +/- 4.4).
  
  
  CONCLUSIONS
  In patients with atrial fibrillation initiated from one or two ArPVs, the diameters of ArPVs were significantly larger than those of non-ArPVs irrespective of the specific PV concerned, which might imply a possible role of PV dilatation in the arrhythmogenesis.
authors.affiliation: Hôpital Cardiologique du Haut-Lévêque, Avenue de Magellan, 33604 Bordeaux-Pessac, France. yamanet1@aol.com
authors.forename: Teiichi
authors.initials: T
authors.lastname: Yamane
authors.forename: Dipen C
authors.initials: DC
authors.lastname: Shah
authors.forename: Pierre
authors.initials: P
authors.lastname: Jaïs
authors.forename: Mélèze
authors.initials: M
authors.lastname: Hocini
authors.forename: Jing Tian
authors.initials: JT
authors.lastname: Peng
authors.forename: Isabel
authors.initials: I
authors.lastname: Deisenhofer
authors.forename: Jacques
authors.initials: J
authors.lastname: Clémenty
authors.forename: Michel
authors.initials: M
authors.lastname: Haïssaguerre
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D004108:Dilatation, Pathologic / Q000000981:diagnostic imaging / Q000503:physiopathology; D004594:Electrophysiology; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011336:Probability; D011446:Prospective Studies; D011667:Pulmonary Veins / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D011859:Radiography; D018570:Risk Assessment; D012680:Sensitivity and Specificity