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KMID : 1011920210220010016
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International Journal of Arrhythmia
2021 Volume.22 No. 1 p.16 ~ p.16
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Left atrial wall thickness and its relationship with reconnection after pulmonary vein isolation in patients with atrial fibrillation evaluated using a three-dimensional wall thickness map
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Oh Se-Il
Joo Yoon-Ha
Lee Eui-Jae
Lee So-Ryoung
Cha Myung-Jin
Choi Eue-Keun
Lee Jung-Chan
Lee Whal
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Abstract
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Background: The major cause of recurrence after pulmonary vein (PV) isolation for atrial fibrillation (AF) is PV reconnection, and thicker wall could be associated with reconnection.
Objectives: This study aimed to evaluate the wall thickness of the PV antrum in reconnection sites using a three-dimensional (3D) wall thickness map.
Methods: A total of 91 patients who underwent a second ablation procedure due to AF recurrence were evaluated. The locations of the PV reconnection sites were confirmed in electroanatomical maps. A 3D atrial wall thickness (AWT) map was created using computed tomography scan data. The AWT values of the ablation lines of the index procedure were graded in each segment of the PV antrum: grade 1, 0.5??2.5 mm.
Results: A total of 281 PV reconnection sites among 1256 segments of the PV antrum in 79 patients were detected. The average AWT grades were 2.7?±?1.0 and 2.2?±?1.0 in the reconnected and non-reconnected segments, respectively (P?
Conclusion: The reconnected segments of the PV antrum showed thicker myocardium than the non-reconnected ones in patients with recurrent AF after catheter ablation. A wall thickness map for PV isolation could be considered for customized ablation in order to reduce PV reconnection.
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KEYWORD
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Catheter ablation, Atrial fibrillation, Pulmonary vein, Wall thickness
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