Abstract
BackgroundThe relationship between focal pulmonary vein potential and atrial fibrillation (AF) has been confirmed. Pulmonary vein (PV) isolation and circumferential pulmonary vein ablation have been the most commonly used procedures of radiofrequency ablation. However, few studies have investigated the relationship between anatomical characteristics of PV and AF recurrences after radiofrequency ablation.MethodologyFor 267 AF patients treated by radiofrequency catheter ablation, the anatomic structure characteristics of pulmonary veins were assessed by multi-slice spiral computed tomography while the values of left atrial diameter (LAD) were measured with transesophageal ultrasonic cardiogram. After radiofrequency catheter ablation, postoperative recurrence was evaluated during a 10-month term follow-up.Principal FindingsDuring follow-up, postoperative recurrence occurred in 44 patients. The mean diameters of LAD, left superior PV, right superior PV, all left PV, and all superior PV were significantly larger in patients with postoperative recurrence (Recurrence vs. Non-recurrence group; 43.9 ± 6.4 mm vs. 40.7 ± 5.6 mm; 18.4 ± 2.1 mm vs. 17.1 ± 3.1 mm; 18.2 ± 2.8 mm vs. 17.2 mm ± 3.9 mm; 16.4 ± 1.5 mm vs. 15.6 ± 2.5 mm; 18.3 ± 2.1 mm vs. 17.1 ± 3.0 mm; respectively; all P < 0.05). Multivariable survival analysis showed that the type and the course of AF, LAD, and the diameters of all superior PV were the independent risk factors for the postoperative recurrence after radiofrequency catheter ablation.ConclusionsThe enlargements of all superior PV and LAD, long course of diseases, and persistent AF were the independent risk factors for the postoperative recurrence after radiofrequency catheter ablation.
Highlights
Atrial fibrillation (AF) is one of the most commonly observed clinical tachyarrhythmias
In order to better evaluate the results of atrial fibrillation (AF) radiofrequency ablation procedures, in the last few years, several studies have assessed numerous factors that may be related to recurrence after radiofrequency ablation, such as age, left atrial size, organic heart disease, type of AF, and duration of AF [2,3]
We found that left atrial diameter, left superior pulmonary vein diameter, overall mean left pulmonary vein diameters, overall mean superior pulmonary vein diameters, AF type, and AF duration were independent risk factors for postoperative recurrence of AF (Table 3)
Summary
Atrial fibrillation (AF) is one of the most commonly observed clinical tachyarrhythmias. In order to better evaluate the results of AF radiofrequency ablation procedures, in the last few years, several studies have assessed numerous factors that may be related to recurrence after radiofrequency ablation, such as age, left atrial size, organic heart disease, type of AF, and duration of AF [2,3]. These important factors might influence the efficacy of radiofrequency ablation but still require further confirmation from large-scale studies. Few studies have investigated the relationship between anatomical characteristics of PV and AF recurrences after radiofrequency ablation
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