Hof Irene, Arbab-Zadeh Armin, Dong Jun, Scherr Daniel, Chilukuri Karuna, Calkins Hugh
Department of Cardiology, Division of Heart and Lungs, University Medical Center, Utrecht, The Netherlands.
Am J Cardiol. 2008 Dec 1;102(11):1567-70. doi: 10.1016/j.amjcard.2008.07.048. Epub 2008 Sep 12.
The success of catheter ablation of atrial fibrillation (AF) is highly dependent on a preprocedural assessment of the size and shape of the left atrium. The most precise method to determine left atrial (LA) volume using computed tomography requires manually tracing the LA area of each cross-sectional image. This is a labor-intensive and time-consuming technique. The purpose of this study was to compare LA volume derived using the "gold-standard" multiple-slice technique with LA volume estimated using 3 orthogonal LA dimensions in patients with AF. The patient population was composed of 100 patients referred for catheter ablation of AF (87 men, mean age 57 +/- 12 years). AF was paroxysmal in 49 patients and persistent in 51. Each patient underwent computed tomography before catheter ablation, and LA volume was measured using the 2 methods. The mean LA volume measured using the multiple-slice technique was 136 +/- 46 ml. According to the simpler estimation approach, the mean LA volume was 112 +/- 41 ml. A close correlation was noted between atrial volumes determined using the 2 methods (r = 0.91, p <0.001). There was a mean underestimation of LA volume by the estimation technique of 17 +/- 13%. In conclusion, the results of this study reveal that LA volume determined using an estimation approach correlates closely with true LA volume as determined using the gold-standard multiple-slice approach. This estimation approach underestimates true LA volume by approximately 20%.
心房颤动（AF）导管消融术的成功高度依赖于术前对左心房大小和形状的评估。使用计算机断层扫描确定左心房（LA）容积的最精确方法需要手动描绘每个横截面图像的LA区域。这是一项劳动强度大且耗时的技术。本研究的目的是比较使用“金标准”多层技术得出的LA容积与使用房颤患者的3个正交LA维度估算的LA容积。患者群体由100名因房颤接受导管消融术的患者组成（87名男性，平均年龄57±12岁）。49例患者为阵发性房颤，51例为持续性房颤。每位患者在导管消融术前均接受计算机断层扫描，并使用两种方法测量LA容积。使用多层技术测量的平均LA容积为136±46 ml。根据更简单的估算方法，平均LA容积为112±41 ml。两种方法测定的心房容积之间存在密切相关性（r = 0.91，p <0.001）。估算技术测定的LA容积平均低估了17±13%。总之，本研究结果表明，使用估算方法测定的LA容积与使用金标准多层方法测定的真实LA容积密切相关。这种估算方法使真实LA容积低估了约20%。
