Prognostic value of pulmonary vein size in prediction of atrial fibrillation recurrence after pulmonary vein isolation: a cardiovascular magnetic resonance study

Journal of Cardiovascular Magnetic Resonance

Research

Ferdinando Baldessin¹  Mark E. Josephson²  Thomas H. Hauser²  Warren J. Manning³  Vidal Essebag⁴  Seth McClennen⁵  Susan B. Yeon⁶ 

[1] Azienda Ospedaliera Treviso, Treviso, Italy;Cardiovascular Division, Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, 330 Brookline Avenue, RW-453, 02215, Boston, Massachusetts;Cardiovascular Division, Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, 330 Brookline Avenue, RW-453, 02215, Boston, Massachusetts;Department of Radiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts;Division of Cardiology, McGill University Health Center, Montreal, Canada;Harbor Medical Associates, South Weymouth, Massachusetts;null;

关键词: Atrial fibrillation;    Catheter ablation;    Cardiovascular magnetic resonance;    Pulmonary vein;   

DOI  :  10.1186/s12968-015-0151-z

 received in 2015-02-26, accepted in 2015-06-01,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundThe relationship between pulmonary vein (PV) anatomy and successful catheter ablation of atrial fibrillation (AF) is poorly understoodMethodsFirst-pass contrast enhanced PV magnetic resonance angiography was performed in 71 consecutive patients prior to PV isolation. PV diameter and cross-sectional area (CSA) were measured prior to PV isolation. Any symptomatic or asymptomatic AF >10s was considered a recurrence. Early recurrence was defined as recurrent AF ≤30 days after PV isolation, while late recurrence of AF was defined as recurrent AF >30 days after.ResultsAt 1 year, 57 % had any recurrence of AF while 41 % had late recurrence of AF. Study subjects with one or more PV diameter in the top 10th percentile had trend toward more early recurrent AF (HR 1.99, p = 0.053). Study subjects with one or more PV CSA in the top 10th percentile had more late recurrent AF (HR 2.25, p = 0.039) and a trend toward more early recurrent AF (HR 1.94, p = 0.064). With multivariate analysis, PV size was not associated with early recurrent AF, but late recurrent AF was associated with one or more large PV, increased left atrial size, and non-paroxysmal AF. Study subjects with all three of these risk factors had a 100 % rate of late recurrent AF at 1 year, while those with none had a 7 % rate of late recurrent AF.ConclusionsLarger PV size is independently associated with more late recurrent AF after PV isolation. Determination of PV size prior to PV isolation may predict procedural success.

【 授权许可】

CC BY   
© Hauser et al. 2015