Relation Between Left Atrial Wall Thickness in Patients with Atrial Fibrillation and Intracardiac Electrogram Characteristics and ATP-Provoked Dormant Pulmonary Vein Conduction

• Published in: Journal of cardiovascular electrophysiology 2015-06, Vol.26 (6), p.597-605
• Main Authors: TAKAHASHI, KEIKO, OKUMURA, YASUO, WATANABE, ICHIRO, NAGASHIMA, KOICHI, SONODA, KAZUMASA, SASAKI, NAOKO, KOGAWA, RIKITAKE, ISO, KAZUKI, OHKUBO, KIMIE, NAKAI, TOSHIKO, HIRAYAMA, ATSUSHI
• Format: Article
• Language: English
• Subjects: Adenosine Triphosphatases - pharmacology; Aged; atrial fibrillation; Atrial Fibrillation - physiopathology; Atrial Remodeling - physiology; Cardiac arrhythmia; Electrophysiologic Techniques, Cardiac; Female; Heart Atria - pathology; Heart Conduction System - drug effects; Heart Rate; Humans; left atrial wall thickness; Male; Middle Aged; PA-LA junction wall thickness; Pulmonary Veins - drug effects; Tomography, X-Ray Computed
• ISSN: 1045-3873; 1540-8167
• DOI: 10.1111/jce.12660

LA Wall Thickness, LA Electrogram, and Dormant PV Conduction Introduction Atrial remodeling plays a key role in development of the substrate for atrial fibrillation (AF). Whether the wall thicknesses of the left atrium (LA) and pulmonary vein (PV)–LA junction affect remodeling and AF ablation is unknown. We investigated the relationship between wall thicknesses, electrogram characteristics, and adenosine triphosphate (ATP)‐provoked dormant PV conduction as they pertain to AF. Methods In 50 patients with AF and 25 patients without AF, wall thicknesses of the LA and PV–LA junction were measured on 320‐slice computed tomography images. For the AF patients, NavX‐based voltage maps generated during sinus rhythm were obtained, and ATP‐provoked dormant PV conduction after PV isolation was evaluated. Results Walls of the LA and PV–LA junction were significantly thicker in the AF patients than in the control patients (1.83 ± 0.29 mm vs. 1.59 ± 0.28 mm, respectively; P = 0.0010; and 0.88 ± 0.14 mm vs. 0.65 ± 0.11 mm, P