Comparative analysis of left atrial size and appendage morphology in paroxysmal and persistent atrial fibrillation patients

IF 2.2 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
J. Pongratz MD, L. Riess MD, S. Hartl MD, B. Brueck MD, C. Tesche MD, MHBA, FESC, FSCCT, D. Olbrich MD, M. Wankerl MD, U. Dorwarth MD, E. Hoffmann MD, FESC, F. Straube MD, FEHRA, FESC, FHRS
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引用次数: 0

Abstract

Purpose

Pulmonary vein isolation (PVI) is effective in treating atrial fibrillation (AF), but outcomes are worse for persistent AF (persAF) patients than paroxysmal AF (PAF) patients. The study aimed to identify differences in left atrial (LA) and left atrial appendage (LAA) anatomy in different AF types.

Methods

In a single-center observational study, a blinded retrospective analysis of preprocedural cardiac computed tomography angiography (CCTA) images was performed. The study evaluated the dimensions of the LA and pulmonary veins (PV), as well as the size and morphology of the LAA using a 3D electroanatomical mapping system.

Results

Between 2012 and 2016, a total of 1103 patients underwent second-generation cryoballoon PVI. Of these, 725 patients (65.7%) had CCTA available, and 473 of these (65.2%) had sufficient quality for measurements. The mean age of the patients was 66.3 ± 9.5 years, and PAF was present in 277 (58.6%) participants. The study found that in persAF patients, LA dimensions such as LA volume [mL] (108; 125; p < .001) or PV ostial dimensions were significantly larger than in those with PAF. LAA volume [mL] (8.3; 9.2; p = .005) and LAA ostial area [mm2] (325; 353; p = .01) were enlarged in persAF. There were no significant differences regarding LAA morphology, with the overall distribution being “windsock” (51%), “chicken-wing” (20%), “cauliflower” (15%), and “cactus” (13%).

Conclusion

Compared to PAF, persAF patients had significantly larger LA as well as LAA dimensions. LAA morphological types were distributed equally in both groups suggesting that LAA morphology may not be associated with the underlying AF type.

Abstract Image

阵发性和持续性心房颤动患者左心房大小和附件形态的比较分析。
目的:肺静脉隔离(PVI)是治疗房颤(AF)的有效方法,但持续性房颤(persAF)患者的预后比阵发性房颤(PAF)患者差。本研究旨在确定不同房颤类型左心房(LA)和左心房附件(LAA)解剖结构的差异。方法:在一项单中心观察性研究中,对术前心脏计算机断层血管造影(CCTA)图像进行了盲法回顾性分析。该研究使用3D电解剖制图系统评估了LA和肺静脉(PV)的尺寸,以及LAA的大小和形态。结果:2012年至2016年,共有1103例患者接受了第二代低温球囊PVI。其中,725例(65.7%)患者可获得CCTA,其中473例(65.2%)具有足够的测量质量。患者平均年龄为66.3±9.5岁,277例(58.6%)患者存在PAF。研究发现,在个人患者中,LA容积等LA尺寸[mL] (108;125年;p p = .005)和LAA开口面积[mm2] (325;353年;p = 0.01)增大。LAA形态差异不显著,总体分布为“风袜”(51%)、“鸡翅”(20%)、“花椰菜”(15%)和“仙人掌”(13%)。结论:与PAF相比,persAF患者的LA和LAA尺寸均明显增大。LAA形态类型在两组中分布均匀,提示LAA形态可能与潜在的AF类型无关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Arrhythmia
Journal of Arrhythmia CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
2.90
自引率
10.00%
发文量
127
审稿时长
45 weeks
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