Anatomical characteristics of pulmonary veins for the prediction of postoperative recurrence after radiofrequency catheter ablation of atrial fibrillation.
BACKGROUND
The relationship between focal pulmonary vein potential and atrial fibrillation (AF) has been confirmed. Pulmonary vein (PV) isolation and circumferential pulmonary vein ablation have been the most commonly used procedures of radiofrequency ablation. However, few studies have investigated the relationship between anatomical characteristics of PV and AF recurrences after radiofrequency ablation.


METHODS
For 267 AF patients treated by radiofrequency catheter ablation, the anatomic structure characteristics of pulmonary veins were assessed by multi-slice spiral computed tomography while the values of left atrial diameter (LAD) were measured with transesophageal ultrasonic cardiogram. After radiofrequency catheter ablation, postoperative recurrence was evaluated during a 10-month term follow-up.


RESULTS
During follow-up, postoperative recurrence occurred in 44 patients. The mean diameters of LAD, left superior PV, right superior PV, all left PV, and all superior PV were significantly larger in patients with postoperative recurrence (Recurrence vs. Non-recurrence group; 43.9 ± 6.4 mm vs. 40.7 ± 5.6 mm; 18.4 ± 2.1 mm vs. 17.1 ± 3.1 mm; 18.2 ± 2.8 mm vs. 17.2 mm ± 3.9 mm; 16.4 ± 1.5 mm vs. 15.6 ± 2.5 mm; 18.3 ± 2.1 mm vs. 17.1 ± 3.0 mm; respectively; all P < 0.05). Multivariable survival analysis showed that the type and the course of AF, LAD, and the diameters of all superior PV were the independent risk factors for the postoperative recurrence after radiofrequency catheter ablation.


CONCLUSIONS
The enlargements of all superior PV and LAD, long course of diseases, and persistent AF were the independent risk factors for the postoperative recurrence after radiofrequency catheter ablation.
Department of Cardiovascular Medicine, East Hospital, Tongji University School of Medicine, Shanghai, China; Department of Cardiovascular Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.
Wei
W
Wei
Department of Cardiovascular Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.
Jun-Bo
JB
Ge
Department of Cardiovascular Medicine, East Hospital, Tongji University School of Medicine, Shanghai, China; Department of Cardiovascular Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.
Yu
Y
Zou
Department of Cardiovascular Medicine, East Hospital, Tongji University School of Medicine, Shanghai, China.
Li
L
Lin
Department of Cardiovascular Medicine, East Hospital, Tongji University School of Medicine, Shanghai, China.
Ying
Y
Cai
Department of Cardiovascular Medicine, East Hospital, Tongji University School of Medicine, Shanghai, China.
Xue-Bo
XB
Liu
Department of Cardiovascular Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.
Wen-Qing
WQ
Zhu
D001281:Atrial Fibrillation / Q000628:therapy*; D017115:Catheter Ablation / Q000379:methods*; D002681:China; D006325:Heart Atria / Q000000981:diagnostic imaging*; D006801:Humans; D011667:Pulmonary Veins / Q000033:anatomy & histology*; D012008:Recurrence; D012044:Regression Analysis; D036542:Tomography, Spiral Computed; D014463:Ultrasonography