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

Hsuan Ming Tsao*, Wei Chih Hu, Mei Han Wu, Ching Tai Tai, Shih Lin Chang, Yenn Jiang Lin, Li Wei Lo, Yu Feng Hu, Tsu Juey Wu, Ming Huei Sheu, Cheng Yen Chang, Shih Ann Chen

*此作品的通信作者

研究成果: Article同行評審

7 引文 斯高帕斯(Scopus)

摘要

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.

原文English
頁(從 - 到)1049-1058
頁數10
期刊International Journal of Cardiovascular Imaging
27
發行號7
DOIs
出版狀態Published - 10月 2011

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