title: Effects of left atrial ablation of atrial fibrillation on size of the left atrium and pulmonary veins.
abstract: OBJECTIVE
  The purpose of this study was to determine the effect of left atrial circumferential ablation on the size of the left atrium and pulmonary veins (PVs).
  
  
  BACKGROUND
  The long-term effects of left atrial circumferential ablation on left atrial and PV size and anatomy have not been analyzed in quantitative fashion.
  
  
  METHODS
  PV and left atrial sizes were analyzed in 41 consecutive patients (mean age 54 +/- 12 years) with paroxysmal (n = 25) or chronic (n = 16) atrial fibrillation. Computed tomography of the chest with three-dimensional reconstruction was performed before and 4 +/- 2 months after left atrial circumferential ablation. Left atrial circumferential ablation was performed to encircle the PVs 1 to 2 cm from the ostia, using a power output of 70 W. Additional ablation lines were created in the posterior left atrium and mitral isthmus. Radiofrequency energy also was delivered within the circles and at the PV ostia in 51% of patients at a reduced power output of 35 W.
  
  
  RESULTS
  At 6 months, 36 patients (88%) were in sinus rhythm without antiarrhythmic drug therapy, including 3 patients (7%) who developed persistent left atrial flutter and underwent subsequent successful ablation of atrial flutter. There was a 15 +/- 16% decrease in left atrial volume (P < .01) and 10 +/- 35% decrease in PV ostial area (P < .01), without focal narrowing, in patients with a successful outcome. Focal PV stenosis did not occur in any of the 41 patients.
  
  
  CONCLUSIONS
  Maintenance of sinus rhythm after left atrial circumferential ablation is associated with reduced left atrial and PV ostial size. Left atrial circumferential ablation for atrial fibrillation does not cause PV stenosis.
authors.affiliation: Division of Cardiology, University of Michigan, Ann Arbor, 48109, USA.
authors.forename: Kristina
authors.initials: K
authors.lastname: Lemola
authors.forename: Michael
authors.initials: M
authors.lastname: Sneider
authors.forename: Benoit
authors.initials: B
authors.lastname: Desjardins
authors.forename: Ian
authors.initials: I
authors.lastname: Case
authors.forename: Aman
authors.initials: A
authors.lastname: Chugh
authors.forename: Burr
authors.initials: B
authors.lastname: Hall
authors.forename: Peter
authors.initials: P
authors.lastname: Cheung
authors.forename: Eric
authors.initials: E
authors.lastname: Good
authors.forename: Jihn
authors.initials: J
authors.lastname: Han
authors.forename: Kamala
authors.initials: K
authors.lastname: Tamirisa
authors.forename: Frank
authors.initials: F
authors.lastname: Bogun
authors.forename: Frank
authors.initials: F
authors.lastname: Pelosi
authors.forename: Ella
authors.initials: E
authors.lastname: Kazerooni
authors.forename: Fred
authors.initials: F
authors.lastname: Morady
authors.forename: Hakan
authors.initials: H
authors.lastname: Oral
mesh_terms: D001281:Atrial Fibrillation / Q000601:surgery*; D017115:Catheter Ablation; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D011667:Pulmonary Veins / Q000000981:diagnostic imaging* / Q000601:surgery; D014057:Tomography, X-Ray Computed