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June 30, 2017International Journal of Clinical Cardiology11 citationsOpen Access

Left Atrial Wall Thickness and Pulmonary Vein Size are Increased in Patients with Atrial Fibrillation Compared to Healthy Controls - A Multidetector Computed Tomography Study

ATAnna F. Thomsen

Key Result

Atrial fibrillation is associated with significantly increased mean left atrial wall thickness (1.7 vs. 1.1 mm) and total pulmonary vein cross-sectional area (1052 vs. 809 mm2) compared to healthy controls.

Study Design

Type

Cross-Sectional (n=94)

Multicenter

No

Structured PICO

Does left atrial wall thickness and pulmonary vein size differ in patients with atrial fibrillation compared to healthy controls?

P
Population
94 participants: 47 patients with paroxysmal or persistent atrial fibrillation scheduled for catheter ablation (mean age 61, 72% male) and 47 age-, BMI-, and gender-matched healthy controls without any history of cardiac disease.
I
Intervention
Multidetector Computed Tomography (MDCT) imaging assessment of Left Atrial Wall Thickness (LAWT) and Pulmonary Vein Cross-Sectional Area (PVCSA)
C
Comparator
Healthy controls without history of cardiac disease
O
Outcome
Left Atrial Wall Thickness (LAWT) and Pulmonary Vein Cross-Sectional Area (PVCSA) measured by MDCTsurrogate

Patients with atrial fibrillation have significantly increased left atrial wall thickness and pulmonary vein size compared to healthy controls, which may reflect atrial remodeling and inform individualized catheter ablation strategies.

Main Result

Absolute Event Rate: 1.7% vs 1.1%

p-value: p=<0.0001

Limitations

  • The number of patients is relatively low.
  • The AF patients consisted of both paroxysmal and persistent AF and initial and repeat ablation, and a complete description of prior therapy approaches is missing.
  • Only 47 out of 137 AF patients were included and the AF history in the control group was unknown.
  • The interobserver variability for LAWT was considerably high reflecting the complexity in technique.
  • Lack of consensus on the exact method for LAWT determination using MDCT
  • Need for larger cohorts
  • Lack of procedural ablation outcomes to correlate with imaging findings
  • Cross-sectional design cannot determine mechanisms behind alterations

Abstract

Atrial Fibrillation (AF) is the most common cardiac arrhythmia and a cause of increased morbidity and mortality. Left Atrial (LA) tissue characteristics play an important role in the pathogenesis of AF. Catheter ablation of AF has emerged as a popular treatment option, however predictors of treatment success are not clearly defined. For a better understanding of the LA structural organization we noninvasively characterized Left Atrial Wall Thickness (LAWT) and Pulmonary Vein Cross-Sectional Area (PVCSA) using Multidetector Computed Tomography (MDCT) in AF patients and healthy controls.

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Cite This Study

Anna F. Thomsen (2017) conducted a cross-sectional in Atrial Fibrillation (n=94). Atrial Fibrillation vs. Healthy controls was evaluated on Mean Left Atrial Wall Thickness (LAWT) in mm (p=<0.0001). Atrial fibrillation is associated with significantly increased mean left atrial wall thickness (1.7 vs. 1.1 mm) and total pulmonary vein cross-sectional area (1052 vs. 809 mm2) compared to healthy controls.

synapsesocial.com/papers/6a1594ca15658026c0828a47https://doi.org/10.23937/2378-2951/1410098
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Left Atrial Wall Thickness Estimated by Cardiac CT: Implications for Catheter Ablation of Atrial Fibrillation2024 · 6 citations
  2. 2Use of Computed Tomography to Identify Atrial Fibrillation Associated Differences in Left Atrial Wall Thickness and Density2012 · 27 citations
  3. 3Left Atrial Wall Thickness Variability Measured by CT Scans 
in Patients Undergoing Pulmonary Vein Isolation2011 · 141 citations
  4. 4Relation Between Left Atrial Wall Thickness in Patients with Atrial Fibrillation and Intracardiac Electrogram Characteristics and ATP‐Provoked Dormant Pulmonary Vein Conduction2015 · 51 citations
  5. 5Left Atrial Posterior Wall Thickness in Patients with and without Atrial Fibrillation: Data from 298 Consecutive Autopsies2008 · 118 citations