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Atrial Volume Reduction Following Catheter Ablation of Atrial Fibrillation and Relation to Reduction in Pulmonary Vein Size: An Evaluation Using Magnetic Resonance Angiography

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Abstract

Introduction: Catheter ablation to achieve pulmonary vein (PV) isolation has become an increasingly used treatment strategy for patients with atrial fibrillation (AF). The purpose of this study was to evaluate the impact of segmental isolation of PVs on volume of left atrium and its relation to the decrease in the size of the pulmonary veins.

Methods: Gadolinium enhanced Magnetic Resonance Angiography (MRA) was performed in 51 AF patients before and 6 ~ 8 weeks post PV isolation, using cooled radio-frequency (RF) energy. Three-dimensional reconstruction with maximum intensity projections and multiplanar reformations was performed. Oblique coronal projections were used to measure the ostial size of PVs. Three orthogonal dimensions of LA chamber were measured and computed to assess the volume of the left atrium.

Results: The mean LA volume decreased by 15.7% after ablation (p < 0.001). The mean PV ostial diameter decreased by 11%, from 18.3 ± 0.8 mm to 16.7 ± 1.0 mm (p = 0.005). Moderate PV stenosis was noted in two veins out of the 192 veins analyzed. There was a significant correlation between changes in the size of PV ostium to that of the LA.

Conclusions: Catheter ablation of AF using a segmental PV isolation approach results in a significant reverse remodeling in the left atrium. Significant stenosis of PVs appears to be rare after the segmental isolation procedure.

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Authors and Affiliations

  1. Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD

    Vinod K. Jayam, Jun Dong, Chandrasekhar R. Vasamreddy, Lars Lickfett, Ritsushi Kato, Timm Dickfeld, Zayd Eldadah, Darshan Dalal, Ronald Berger, Henry R. Halperin & Hugh Calkins MD

  2. Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD

    David A. Blumke & Henry R. Halperin

  3. Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD

    Henry R. Halperin

  4. The Johns Hopkins Hospital, 600 North Wolfe Street, Carnegie 592, Baltimore, Maryland, 21287-0409

    Hugh Calkins MD

Authors
  1. Vinod K. Jayam
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  2. Jun Dong
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  3. Chandrasekhar R. Vasamreddy
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  4. Lars Lickfett
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  5. Ritsushi Kato
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  6. Timm Dickfeld
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  7. Zayd Eldadah
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  8. Darshan Dalal
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  9. David A. Blumke
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  10. Ronald Berger
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  11. Henry R. Halperin
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  12. Hugh Calkins MD
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Corresponding author

Correspondence to Hugh Calkins MD.

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These two authors contributed equally to this study and are the principle investigators.

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Jayam, V.K., Dong, J., Vasamreddy, C.R. et al. Atrial Volume Reduction Following Catheter Ablation of Atrial Fibrillation and Relation to Reduction in Pulmonary Vein Size: An Evaluation Using Magnetic Resonance Angiography. J Interv Card Electrophysiol 13, 107–114 (2005). https://doi.org/10.1007/s10840-005-0215-3

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  • DOI: https://doi.org/10.1007/s10840-005-0215-3

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