Document Detail


Effect of left atrial circumferential ablation for atrial fibrillation on left atrial transport function.
MedLine Citation:
PMID:  16171744     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The effects of left atrial (LA) circumferential ablation on LA function in patients with atrial fibrillation (AF) have not been well described. OBJECTIVES: The purpose of this study was to determine the effect of LA circumferential ablation on LA function. METHODS: Gated, multiphase, dynamic contrast-enhanced computed tomographic (CT) scans of the chest with three-dimensional reconstructions of the heart were used to calculate the LA ejection fraction (EF) in 36 patients with paroxysmal (n = 27) or chronic (n = 9) AF (mean age 55 +/- 11 years) and in 10 control subjects with no history of AF. Because CT scans had to be acquired during sinus rhythm, a CT scan was available both before and after (mean 5 +/- 1 months) LA circumferential ablation (LACA) in only 10 patients. A single CT scan was acquired in 8 patients before and in 18 patients after LACA ablation. Radiofrequency catheter ablation was performed using an 8-mm-tip catheter to encircle the pulmonary veins, with additional lines along the mitral isthmus and the roof. RESULTS: In patients with paroxysmal AF, LA EF was lower after than before LACA (21% +/- 8% vs 32 +/- 13%, P = .003). LA EF after LA catheter ablation was similar among patients with paroxysmal AF and those with chronic AF (21% +/- 8% vs 23 +/- 13%, P = .7). However, LA EF after LA catheter ablation was lower in all patients with AF than in control subjects (21% +/- 10% vs 47% +/- 5%, P < .001). CONCLUSION: During medium-term follow-up, restoration of sinus rhythm by LACA results in partial return of LA function in patients with chronic AF. However, in patients with paroxysmal AF, LA catheter ablation results in decreased LA function. Whether the impairment in LA function is severe enough to predispose to LA thrombi despite elimination of AF remains to be determined.
Authors:
Kristina Lemola; Benoit Desjardins; Michael Sneider; Ian Case; Aman Chugh; Eric Good; Jihn Han; Kamala Tamirisa; Ariane Tsemo; Scott Reich; David Tschopp; Petar Igic; Darryl Elmouchi; Frank Bogun; Frank Pelosi; Ella Kazerooni; Fred Morady; Hakan Oral
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Heart rhythm : the official journal of the Heart Rhythm Society     Volume:  2     ISSN:  1547-5271     ISO Abbreviation:  Heart Rhythm     Publication Date:  2005 Sep 
Date Detail:
Created Date:  2005-09-20     Completed Date:  2006-06-06     Revised Date:  2009-10-27    
Medline Journal Info:
Nlm Unique ID:  101200317     Medline TA:  Heart Rhythm     Country:  United States    
Other Details:
Languages:  eng     Pagination:  923-8     Citation Subset:  IM    
Affiliation:
Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, Michigan 48109, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Atrial Fibrillation / physiopathology*,  radiography,  surgery*
Atrial Function, Left*
Case-Control Studies
Catheter Ablation*
Chronic Disease
Electrophysiologic Techniques, Cardiac
Female
Follow-Up Studies
Heart Atria / physiopathology,  radiography,  surgery
Heart Conduction System / physiopathology,  radiography,  surgery
Humans
Male
Middle Aged
Predictive Value of Tests
Radiographic Image Interpretation, Computer-Assisted
Stroke Volume
Tomography, X-Ray Computed / methods
Treatment Outcome
Comments/Corrections
Comment In:
Heart Rhythm. 2005 Sep;2(9):929-30   [PMID:  16171745 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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