Cardiology Service, University Hospital of Geneva, 4, rue Gabrielle-Perret-Gentil, Geneva 1211, Switzerland.
Europace. 2010 Jun;12(6):792-7. doi: 10.1093/europace/euq031. Epub 2010 Feb 25.
Left atrial (LA) volume can be determined during radiofrequency catheter ablation (RFCA) of atrial fibrillation (AF) with angiography or electro-anatomic (CARTO) mapping. We compared these volumes with LA volume measured using transthoracic real-time three-dimensional echocardiography (3DE).
One hundred and twenty-seven consecutive patients undergoing RFCA for AF were studied using biplane pulmonary vein angiography with opacification of the LA. LA volume was calculated from the diameter measurements with a formula using an ellipsoid model. A subset of 22 patients also underwent LA volume determination by CARTO mapping. These volumes were then correlated with LA volume determined non-invasively by real-time 3DE. Linear regression showed a significant correlation between LA volume determined by angiography and 3DE volume (r = 0.56, P < 0.0001). Bland-Altman analysis showed a bias of 38 +/- 22 ml by the angiographic method. LA volume measured using CARTO correlated better (r = 0.67, P < 0.001), but 3DE yielded smaller values (mean difference of -30 +/- 19 ml).
LA volume determination by angiography and CARTO mapping correlate significantly with 3DE volume. However, both invasive techniques yield larger values for LA volume. The results indicate that LA volume obtained by angiography or CARTO should not be used as baseline value for non-invasive follow-up of LA remodelling by 3DE.
左心房（LA）容积可在心房颤动（AF）的射频导管消融（RFCA）过程中通过血管造影或电解剖（CARTO）标测来确定。我们将这些容积与经胸实时三维超声心动图（3DE）测量的 LA 容积进行了比较。
我们研究了 127 例连续接受 AF 的 RFCA 患者，使用双平面肺静脉造影术使 LA 显影。LA 容积通过使用椭圆体模型的公式从直径测量值计算得出。22 例患者亚组还接受了 CARTO 标测的 LA 容积测定。然后将这些容积与实时 3DE 非侵入性测定的 LA 容积进行相关性分析。线性回归显示血管造影法和 3DE 容积之间存在显著相关性（r = 0.56，P < 0.0001）。Bland-Altman 分析显示血管造影法存在 38 +/- 22 ml 的偏差。CARTO 测量的 LA 容积相关性更好（r = 0.67，P < 0.001），但 3DE 产生的容积值较小（平均差值为 -30 +/- 19 ml）。
血管造影和 CARTO 标测法测定的 LA 容积与 3DE 容积显著相关。然而，两种侵入性技术均会导致 LA 容积值偏大。这些结果表明，血管造影或 CARTO 获得的 LA 容积不应作为 3DE 进行非侵入性随访 LA 重构的基线值。
