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Characterization of the dynamic function of the pulmonary veins before and after atrial fibrillation ablation using multi-detector computed tomographic images

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Abstract

Understanding pulmonary vein (PV) function before and after catheter ablation can validate the benefit of the treatment and provide mechanistic insight into atrial fibrillation (AF). This study was aimed to investigate the functional remodeling process of PVs by multi-detector computed tomography (MDCT). We assessed the dynamic function of four PVs by MDCT at systolic and diastolic phases. Twelve points around each PV ostium were used to assess the magnitude and abnormalities of the regional wall motion. The axis of PV shifting during cardiac cycle was also determined. Seventy-four paroxysmal AF patients and 29 controls were enrolled. In those of AF, the superior PVs had poorer contractile function (ejection fraction: P = 0.01 for left; P = 0.009 for right; magnitude of the motion: P = 0.01 for left; P = 0.02 for right) which mainly resulted from the decreased movement of the posterior wall. In contrast, the function of inferior PVs was similar between two groups. After a mean follow-up of 158 ± 95 days, the PV motion improved in the patients without any AF recurrence. In addition, analysis of the pre-ablation PV function showed that the angles, which shifted during cardiac cycle of left (P = 0.035) and right (P = 0.014) inferior PV, were significantly decreased in recurrent patients. The contractile function of the superior PVs was impaired in paroxysmal AF patients. This was attributed to the hypokinesia of the posterior wall of PVs and improved after circumferential ablation in the patients without recurrence. MDCT images can effectively delineate the functional characteristics of PVs.

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Acknowledgments

We thank Miss Shan-Su Huang for the technical assistance for analysis of CT images. This study is supported by grant from National Science Council (NSC 97-2314-B-010-042-MY3), Taiwan

Conflict of interest

The authors have no conflicts of interest to disclose

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Authors and Affiliations

  1. Division of Cardiology, National Yang Ming University Hospital and National Yang Ming University, No 152, Xin-Min Road, Yi-Lan, Taiwan, R.O.C.

    Hsuan-Ming Tsao

  2. Division of Cardiology, Taipei Veterans General Hospital, Taipei, Taiwan

    Ching-Tai Tai, Shih-Lin Chang, Yenn-Jiang Lin, Li-Wei Lo, Yu-Feng Hu & Shih-Ann Chen

  3. Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan

    Mei-Han Wu, Ming-Huei Sheu & Cheng-Yen Chang

  4. Division of Cardiology, Taichung Veterans General Hospital, TaiChung, Taiwan

    Tsu-Juey Wu

  5. Department of Biomedical Engineering, Chung Yuan Christian Univerisity, Chung-Li, Taiwan

    Wei-Chih Hu

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  1. Hsuan-Ming Tsao
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  2. Wei-Chih Hu
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Correspondence to Hsuan-Ming Tsao.

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Tsao, HM., Hu, WC., Wu, MH. et al. Characterization of the dynamic function of the pulmonary veins before and after atrial fibrillation ablation using multi-detector computed tomographic images. Int J Cardiovasc Imaging 27, 1049–1058 (2011). https://doi.org/10.1007/s10554-010-9752-7

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  • DOI: https://doi.org/10.1007/s10554-010-9752-7

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