title: Left atrial posterior wall thickness in patients with and without atrial fibrillation: data from 298 consecutive autopsies.
abstract: BACKGROUND
  Radiofrequency ablation of atrial fibrillation (AF) is associated with energy delivery on the posterior left atrial (LA) wall with small but significant risk of life-threatening complications. Anatomy of LA walls has been described, but wall thickness in patients with AF has not been studied systematically. The aim of the present study was to describe LA posterior wall thickness in patients with and without history of AF.
  
  
  RESULTS
  Heart mass and LA wall thickness was measured during 298 consecutive autopsies (142 male, age 61 +/- 17 years). LA posterior wall was measured at three levels: between the superior pulmonary veins (SPV), in the center of the posterior LA wall (CPV), and between the inferior pulmonary veins (IPV). Information about AF history was obtained from medical records. Fifty-nine subjects (20%) had documented AF. They were older than subjects without AF (74 +/- 10 years vs 58 +/- 17 years, P < 0.0001) and had greater heart mass (522 +/- 114 g vs 389 +/- 99 g, P < 0.0001). LA posterior wall thickness increased from the most superior to the most inferior measured level (2.3 +/- 0.9 mm vs 2.5 +/- 1.0 mm vs 2.9 +/- 1.3 mm for SPV, CPV, and IPV, respectively; P < 0.001). Subjects with AF history had thinner LA posterior wall at CPV and IPV compared with those without AF.
  
  
  CONCLUSIONS
  LA posterior wall thickness is described on a large series of consecutive autopsies. LA posterior wall is found to be generally thinner in patients with history of AF. Study results have clinical implications for understanding complication risk and improvement of safety of AF ablation procedures.
authors.affiliation: Department of Cardiology, Lund University Hospital and Center for Integrative Electrocardiology at Lund University (CIEL), Lund, Sweden. Pyotr.Platonov@med.lu.se
authors.forename: Pyotr G
authors.initials: PG
authors.lastname: Platonov
authors.forename: Vitaly
authors.initials: V
authors.lastname: Ivanov
authors.forename: Siew Yen
authors.initials: SY
authors.lastname: Ho
authors.forename: Lubov
authors.initials: L
authors.lastname: Mitrofanova
mesh_terms: D000369:Aged, 80 and over; D000886:Anthropometry / Q000379:methods; D001281:Atrial Fibrillation / Q000473:pathology*; D001344:Autopsy; D005260:Female; D006325:Heart Atria / Q000473:pathology*; D006801:Humans; D008297:Male