title: Reversal of pulmonary vein remodeling after catheter ablation of atrial fibrillation.
abstract: BACKGROUND
  Pulmonary veins (PV) and the atria undergo electrical and structural remodeling in atrial fibrillation (AF). This study aimed to determine PV and left atrial (LA) reverse remodeling after catheter ablation for AF assessed by chest computed tomography (CT).
  
  
  METHODS
  PV electrophysiologic studies and catheter ablation were performed in 63 patients (68% male; mean ± SD age: 56 ± 10 years) with symptomatic AF (49% paroxysmal, 51% persistent). Chest CT was performed before and 3 months after catheter ablation.
  
  
  RESULTS
  At baseline, patients with persistent AF had a greater LA volume (91 ± 29 cm(3) vs. 66 ± 27 cm(3); P = 0.003) and mean PV ostial area (241 ± 43 mm(2) vs. 212 ± 47 mm(2); P = 0.03) than patients with paroxysmal AF. There was no significant correlation between the effective refractory period and the area of the left superior PV ostium. At 3 months of follow-up after ablation, 48 patients (76%) were AF free on or off antiarrhythmic drugs. There was a significant reduction in LA volume (77 ± 31 cm(3) to 70 ± 28 cm(3); P < 0.001) and mean PV ostial area (224 ± 48 mm(2) to 182 ± 43 mm(2); P < 0.001). Patients with persistent AF had more reduction in LA volume (11.8 ± 12.8 cm(3) vs. 4.0 ± 11.2 cm(3); P = 0.04) and PV ostial area (62 mm(2) vs. 34 mm(2); P = 0.04) than those who have paroxysmal AF. The reduction of the averaged PV ostial area was significantly correlated with the reduction of LA volume (r = 0.38, P = 0.03).
  
  
  CONCLUSIONS
  Catheter ablation of AF improves structural remodeling of PV ostia and left atrium. This finding is more apparent in patients with persistent AF treated by catheter ablation.
authors.affiliation: Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, China; Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Jia-Hui
authors.initials: JH
authors.lastname: Wu
authors.affiliation: Heart Rhythm Specialists, Phoenix, Arizona, USA.
authors.forename: Hung-Kei
authors.initials: HK
authors.lastname: Li
authors.affiliation: Prairie Cardiovascular Consultants, Ltd., Springfield, Illinois, USA.
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Couri
authors.affiliation: Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Philip A
authors.initials: PA
authors.lastname: Araoz
authors.affiliation: Department of Cardiovascular Medicine, Mackay Memorial Hospital, Taipei, Taiwan, China; Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Ying-Hsiang
authors.initials: YH
authors.lastname: Lee
authors.affiliation: Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, China.
authors.forename: Chang-Sheng
authors.initials: CS
authors.lastname: Ma
authors.affiliation: Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Douglas L
authors.initials: DL
authors.lastname: Packer
authors.affiliation: Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Yong-Mei
authors.initials: YM
authors.lastname: Cha
keywords: Ablation; Atrial fibrillation; Computed tomography; Left atrium; Pulmonary vein isolation; Pulmonary vein ostial area