Thickening of the left atrial wall shortly after radiofrequency ablation predicts early recurrence of atrial fibrillation.
BACKGROUND
Inflammatory responses following atrial fibrillation (AF) ablation may aggravate arrhythmogenic activity and cause an early recurrence of AF (ERAF).


RESULTS
In 56 patients who underwent circumferential pulmonary vein ablation (CPVA) for paroxysmal AF, cardiovascular magnetic resonance imaging (CMRI) was evaluated in 5 subdivided left atrial (LA) regions before the CPVA and at 1 day and 1 month after. At a mean of 7+/-10 days after the CPVA, 23 patients (41%) developed 1 or more episodes of AF (ERAF group), while 33 patients (59%) remained free from AF during the first month of follow up (no-ERAF group). LA wall thickness increased 1 day after the CPVA in both groups, as demonstrated by high T2-weighted signal. The LA roof thickness and its increase, however, were greater in the ERAF group than in the no-ERAF group (P<0.05). Regions of delayed enhancement (DE) were also frequently detected in both groups, but the total number of DE regions did not differ between the 2 groups. The thickening of the LA wall associated with a high T2-weighted signal resolved within 1 month. No significant difference between the 2 groups was found in any of the CMRI parameters before or 1 month after CPVA.


CONCLUSIONS
Thickening of the LA roof shortly after CPVA may predict an ERAF.
Yokokawa
Miki
M
Division of Cardiology, Gunma Prefectural Cardiovascular Center, Maebashi, Japan.
Tada
Hiroshi
H
Koyama
Keiko
K
Ino
Toshihiko
T
Naito
Shigeto
S
Oshima
Shigeru
S
Taniguchi
Koichi
K
D000368:Aged; D001281:Atrial Fibrillation / Q000473:pathology* / Q000628:therapy; D017115:Catheter Ablation / Q000009:adverse effects*; D005260:Female; D006325:Heart Atria / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D012008:Recurrence; D013997:Time Factors