Reversal of pulmonary vein remodeling after catheter ablation of atrial fibrillation

Jia Hui Wu, Hung Kei Li, Daniel M. Couri, Philip A Araoz, Ying Hsiang Lee, Chang Sheng Ma, Douglas L Packer, Yong-Mei Cha

Research output: Contribution to journalArticle

3 Scopus citations

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 cm3 vs. 66 ± 27 cm3; P = 0.003) and mean PV ostial area (241 ± 43 mm2 vs. 212 ± 47 mm2; 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 cm3 to 70 ± 28 cm3; P <0.001) and mean PV ostial area (224 ± 48 mm2 to 182 ± 43 mm2; P <0.001). Patients with persistent AF had more reduction in LA volume (11.8 ± 12.8 cm3 vs. 4.0 ± 11.2 cm3; P = 0.04) and PV ostial area (62 mm2 vs. 34 mm2; 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.

Original languageEnglish (US)
Pages (from-to)163-168
Number of pages6
JournalJournal of Geriatric Cardiology
Volume13
Issue number2
DOIs
StatePublished - 2016

Keywords

  • Ablation
  • Atrial fibrillation
  • Computed tomography
  • Left atrium
  • Pulmonary vein isolation
  • Pulmonary vein ostial area

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Geriatrics and Gerontology

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