Prevalence and severity of left atrial edema detected by electron beam tomography early after pulmonary vein ablation.
OBJECTIVE
The aim of this study was to investigate the prevalence and severity of left atrial (LA) edema after pulmonary vein (PV) ablation and its effect on the cardiac function.


BACKGROUND
Though extensive LA catheter ablation has been demonstrated to be more effective in curing paroxysmal atrial fibrillation (PAF) than segmental ostial pulmonary vein isolation (S-PVI), it might cause life-threatening complications, including congestive heart failure associated with LA edema.


METHODS
Fifty patients underwent S-PVI (Group S) and 27 underwent circumferential PV antrum ablation (Group C) for drug-refractory PAF. Enhanced electron beam tomography (EBT) was performed before, 1 or 2 days after, and 1 month after the PV ablation, and transthoracic ultrasound cardiography (UCG) was performed 1 month after the PV ablation in all patients.


RESULTS
The EBT assessment revealed LA edema immediately after the PV ablation in 47 Group S patients and all Group C patients. The severity of the LA edema, number of radiofrequency applications, and amount of radiofrequency energy delivered during the PV ablation was significantly greater in Group C than in Group S. One month after the PV ablation, in all patients, the EBT assessment revealed that those edematous changes had disappeared, and the UCG assessment showed no reduction in the cardiac function.


CONCLUSIONS
Left atrial edema was observed in a large portion of the patients immediately after the PV ablation, and the severity of the LA edema depended on the extent and amount of the radiofrequency energy delivered in the PV ablation. The LA edema soon disappeared naturally and did not reduce the cardiac function.
Okada
Taro
T
Division of Cardiology, Aichi Prefectural Cardiovascular and Respiratory Center, Ichinomiya, Japan.
Yamada
Takumi
T
Murakami
Yoshimasa
Y
Yoshida
Naoki
N
Ninomiya
Yuuichi
Y
Shimizu
Takeshi
T
Toyama
Junji
J
Yoshida
Yukihiko
Y
Ito
Teruo
T
Tsuboi
Naoya
N
Kondo
Takahisa
T
Inden
Yasuya
Y
Hirai
Makoto
M
Murohara
Toyoaki
T
D001281:Atrial Fibrillation / Q000601:surgery; D017115:Catheter Ablation; D004489:Edema, Cardiac / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000453:epidemiology*; D005260:Female; D006325:Heart Atria; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011667:Pulmonary Veins / Q000601:surgery*; D012720:Severity of Illness Index; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography