Left atrial wall thickness variability measured by CT scans in patients undergoing pulmonary vein isolation

Roy Beinart, Suhny Abbara, Andrew Blum, Maros Ferencik, Kevin Heist, Jeremy Ruskin, Moussa Mansour

Research output: Contribution to journalArticle

56 Citations (Scopus)

Abstract

Left Atrial Wall Thickness Variability Measured by CT Scans. Introduction: Successful catheter ablation of atrial fibrillation (AF) requires the creation of transmural lesions in the left atrium (LA). In addition, cardiac perforation is more likely to occur in areas of thin walls. The LA wall thickness is thus relevant both for procedural efficacy and safety. This study sought to evaluate the regional LA wall thickness in patients with AF. Methods: The LA muscular wall thickness (excluding fat) was measured by 64 slice cardiac computed tomography (CT) in 60 patients with persistent AF prior to catheter ablation procedures. Measurements were performed in all patients at 12 distinct LA locations, including 3 at the roof (right, middle left), 3 at the floor (right, middle, left), 4 at the posterior wall (right, middle, middle-superior, left), 1 at the left lateral ridge (LLR), and 1 at the mitral isthmus. Results: There was a large range of LA wall thickness (average thickness 1.89 ± 0.48 mm, range 0.5-3.5 mm). In addition, there were significant regional differences in LA wall thickness. In particular, the LA roof was significantly thicker than the posterior wall and floor (P <0.001), the LLR was significantly thicker than most regions (P <0.04), and the mitral isthmus was also significantly thicker than the posterior wall (P <0.001) and floor (P <0.001). Conclusions: In patients with persistent AF, there is inter- and intra-patient variability in the thickness of the LA muscular wall. In most patients, however, the roof, mitral isthmus, and the ridge between the pulmonary veins and appendage are thicker compared to the posterior wall and floor.

Original languageEnglish (US)
Pages (from-to)1232-1236
Number of pages5
JournalJournal of Cardiovascular Electrophysiology
Volume22
Issue number11
DOIs
StatePublished - Nov 2011
Externally publishedYes

Fingerprint

Pulmonary Veins
Heart Atria
Tomography
Atrial Fibrillation
Catheter Ablation
Fats
Safety

Keywords

  • atrial fibrillation
  • catheter ablation
  • CT scan
  • left atrium
  • pulmonary vein isolation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Left atrial wall thickness variability measured by CT scans in patients undergoing pulmonary vein isolation. / Beinart, Roy; Abbara, Suhny; Blum, Andrew; Ferencik, Maros; Heist, Kevin; Ruskin, Jeremy; Mansour, Moussa.

In: Journal of Cardiovascular Electrophysiology, Vol. 22, No. 11, 11.2011, p. 1232-1236.

Research output: Contribution to journalArticle

Beinart, Roy ; Abbara, Suhny ; Blum, Andrew ; Ferencik, Maros ; Heist, Kevin ; Ruskin, Jeremy ; Mansour, Moussa. / Left atrial wall thickness variability measured by CT scans in patients undergoing pulmonary vein isolation. In: Journal of Cardiovascular Electrophysiology. 2011 ; Vol. 22, No. 11. pp. 1232-1236.
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abstract = "Left Atrial Wall Thickness Variability Measured by CT Scans. Introduction: Successful catheter ablation of atrial fibrillation (AF) requires the creation of transmural lesions in the left atrium (LA). In addition, cardiac perforation is more likely to occur in areas of thin walls. The LA wall thickness is thus relevant both for procedural efficacy and safety. This study sought to evaluate the regional LA wall thickness in patients with AF. Methods: The LA muscular wall thickness (excluding fat) was measured by 64 slice cardiac computed tomography (CT) in 60 patients with persistent AF prior to catheter ablation procedures. Measurements were performed in all patients at 12 distinct LA locations, including 3 at the roof (right, middle left), 3 at the floor (right, middle, left), 4 at the posterior wall (right, middle, middle-superior, left), 1 at the left lateral ridge (LLR), and 1 at the mitral isthmus. Results: There was a large range of LA wall thickness (average thickness 1.89 ± 0.48 mm, range 0.5-3.5 mm). In addition, there were significant regional differences in LA wall thickness. In particular, the LA roof was significantly thicker than the posterior wall and floor (P <0.001), the LLR was significantly thicker than most regions (P <0.04), and the mitral isthmus was also significantly thicker than the posterior wall (P <0.001) and floor (P <0.001). Conclusions: In patients with persistent AF, there is inter- and intra-patient variability in the thickness of the LA muscular wall. In most patients, however, the roof, mitral isthmus, and the ridge between the pulmonary veins and appendage are thicker compared to the posterior wall and floor.",
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