title: Efficacy of pulmonary vein isolation on left atrial function in paroxysmal and persistent atrial fibrillation and the dependency on its baseline function.
abstract: BACKGROUND
  The effects of pulmonary vein (PV) isolation in atrial fibrillation (AF) on left atrial (LA) function or PV flow have not been well documented.
  
  
  METHODS
  We examined the LA function and PV flow before and 3-6 months after PV isolation in 67 AF patients (34 paroxysmal [PAF] and 33 persistent [CAF]) using transesophageal echocardiography.
  
  
  RESULTS
  AF recurred in 6/34 patients with PAF and in 6/33 patients with CAF 6 months after PV isolation. A larger LA dimension, a lower systolic PV flow velocity, and a lower ratio of systolic to diastolic PV flow velocity were related to a higher incidence of AF recurrence. The increment of left atrial appendage (LAA) flow velocity (55% vs. 22%) and systolic PV flow velocity (57% vs. 20%) after PV isolation tended to be greater in CAF than in PAF. The changes in LAA flow velocity had reverse correlations with the baseline values before PV isolation (PAF: r = -0.73, CAF: r = -0.58). The changes in mitral flow velocity during atrial contraction in PAF had reverse correlations with the baseline values before PV isolation (r = -0.84). The changes in systolic and diastolic PV flow velocity of PAF had reverse correlations with the baseline values before PV isolation (r = -0.56, r = -0.66).
  
  
  CONCLUSIONS
  The baseline LA function may affect AF recurrence as well as the improvement of LA function, and the benefit of successful PV isolation might be greater in CAF than in PAF.
authors: Echocardiography Division, Department of Laboratory Medicine, Hiroshima Prefectural Hospital, Hiroshima, Japan. n_yoshida0210@ybb.ne.jp
authors: Naoyasu
authors: N
authors: Yoshida
authors: Mitsunori
authors: M
authors: Okamoto
authors: Hidekazu
authors: H
authors: Hirao
authors: Kazuyoshi
authors: K
authors: Suenari
authors: Kiyomi
authors: K
authors: Nanba
authors: Hiroki
authors: H
authors: Kinoshita
authors: Masaya
authors: M
authors: Matsumura
authors: Mio
authors: M
authors: Uchida
authors: Mirai
authors: M
authors: Kinoshita
authors: Yuichiro
authors: Y
authors: Watari
authors: Yukihiro
authors: Y
authors: Fukuda
authors: Hironori
authors: H
authors: Ueda
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000601:surgery*; D016279:Atrial Function, Left; D017115:Catheter Ablation / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D015995:Prevalence; D011667:Pulmonary Veins / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014463:Ultrasonography
keywords: atrial fibrillation; left atrial appendage function; left atrial function; pulmonary vein flow; radiofrequency catheter ablation