Abstract 12191: Assessment of Pulmonary Vein Contraction with 320-Slice Computed Tomography: Impact of Pulmonary Vein Isolation for Paroxysmal and Non-Paroxysmal Atrial Fibrillation
Background: Non-invasive methods to evaluate long-term successful pulmonary vein (PV) isolation remain to be established. We hypothesized that evaluating left atrial (LA) and PV function before and after radiofrequency catheter ablation (RFCA) would be useful for the validation of successful treatment of atrial fiblliration (AF). The purpose of the present study was to investigate the functional remodeling process of LA and PVs using 320-slice multi-slice computed tomography (MSCT).
Methods: Twenty-five patients (63.3±8.2 years, 17 males) with paroxysmal AF (PAF) and 25 patients (63.5±8.2 years, 23 males) with non-paroxysmal AF (NPAF) were enrolled. MSCT was performed before and after RFCA with a 320-slice scanner. Images were reconstructed at 10 phases of one cardiac cycle (from 5% to 95% of the R-R interval). Using multi-planar reconstruction, the location of the PV ostium was defined, and the PV ejection fraction was calculated as the volume change of the first 10mm from the ostium using Simpson's disc methods. The maximal LA volume and the ejection fraction of LA and each PV (right superior PV: RSPV, right inferior PV: RIPV, left superior PV: LSPV, left inferior PV: LIPV) were calculated before and after RFCA for PAF and NPAF patients.
Results: Maximal LA volumes were significantly decreased in both PAF and NPAF patients after RFCA (Table). However, EF significantly improved only in NPAF patients. In PV analysis, the EFs in RSPV were significantly decreased after RFCA both in PAF and NPAF patients. The EF in LSPV was significantly decreased only in PAF patients.
Conclusions: PV contraction tended to decrease after RFCA, especially in RSPV of both PAF and NPAF patients and LSPV in PAF patients. MSCT is useful to delineate the functional changes of LA and PVs.
- © 2011 by American Heart Association, Inc.