Document Detail


Characterization of the dynamic function of the pulmonary veins before and after atrial fibrillation ablation using multi-detector computed tomographic images.
MedLine Citation:
PMID:  21110102     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Understanding pulmonary vein (PV) function before and after catheter ablation can validate the benefit of the treatment and provide mechanistic insight into atrial fibrillation (AF). This study was aimed to investigate the functional remodeling process of PVs by multi-detector computed tomography (MDCT). We assessed the dynamic function of four PVs by MDCT at systolic and diastolic phases. Twelve points around each PV ostium were used to assess the magnitude and abnormalities of the regional wall motion. The axis of PV shifting during cardiac cycle was also determined. Seventy-four paroxysmal AF patients and 29 controls were enrolled. In those of AF, the superior PVs had poorer contractile function (ejection fraction: P = 0.01 for left; P = 0.009 for right; magnitude of the motion: P = 0.01 for left; P = 0.02 for right) which mainly resulted from the decreased movement of the posterior wall. In contrast, the function of inferior PVs was similar between two groups. After a mean follow-up of 158 ± 95 days, the PV motion improved in the patients without any AF recurrence. In addition, analysis of the pre-ablation PV function showed that the angles, which shifted during cardiac cycle of left (P = 0.035) and right (P = 0.014) inferior PV, were significantly decreased in recurrent patients. The contractile function of the superior PVs was impaired in paroxysmal AF patients. This was attributed to the hypokinesia of the posterior wall of PVs and improved after circumferential ablation in the patients without recurrence. MDCT images can effectively delineate the functional characteristics of PVs.
Authors:
Hsuan-Ming Tsao; Wei-Chih Hu; Mei-Han Wu; Ching-Tai Tai; Shih-Lin Chang; Yenn-Jiang Lin; Li-Wei Lo; Yu-Feng Hu; Tsu-Juey Wu; Ming-Huei Sheu; Cheng-Yen Chang; Shih-Ann Chen
Publication Detail:
Type:  Journal Article     Date:  2010-11-26
Journal Detail:
Title:  The international journal of cardiovascular imaging     Volume:  27     ISSN:  1875-8312     ISO Abbreviation:  Int J Cardiovasc Imaging     Publication Date:  2011 Oct 
Date Detail:
Created Date:  2011-09-29     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100969716     Medline TA:  Int J Cardiovasc Imaging     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1049-58     Citation Subset:  IM    
Affiliation:
Division of Cardiology, National Yang Ming University Hospital and National Yang Ming University, No 152, Xin-Min Road, Yi-Lan, Taiwan, R.O.C., hmtsao.pohai@msa.hinet.net.
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