左心房壁厚度：与房颤导管消融相关的解剖学方面。
Left atrial wall thickness: anatomic aspects relevant to catheter ablation of atrial fibrillation.
机构信息
Department of Cardiology, Shanghai Chest Hospital Affiliated to Shanghai Jiao Tong University, Shanghai 200030, China.
出版信息
Chin Med J (Engl). 2012 Jan;125(1):12-5.
BACKGROUND
The success and complication rates of atrial fibrillation (AF) ablation may be related to regional differences in left atrial (LA) wall thickness. The purpose of this study was to investigate the transmural LA wall thickness in various regions.
METHODS
We measured LA wall thickness in 36 human heart specimens using calipers at three planes including left pulmonary veins (PVs) vestibule plane, right PVs vestibule plane and the middle plane between the two. In each plane, eight points were selected, including superior, middle and inferior levels at anterior and posterior wall, roof and bottom.
RESULTS
The anterior and posterior wall thickness displayed gradient from superior to inferior level (anterior wall: (2.73 ± 1.01) mm, (2.08 ± 0.91) mm and (1.54 ± 0.69) mm; posterior wall: (1.74 ± 0.68) mm, (1.48 ± 0.39) mm and (1.27 ± 0.42) mm). At the roof, LA wall thickness was thickest in middle plane ((2.01 ± 1.02) mm) and was thinnest in left PVs vestibule plane ((1.29 ± 0.41) mm). The posterior wall thickness in left PVs vestibule plane was thinner than in the other two planes (P < 0.05 - 0.001), and was thinner in right PVs vestibule plane than in middle plane (P < 0.01 - 0.001). Whereas in anterior wall, the wall thickness in left PVs vestibule plane was thicker than in middle and right PVs vestibule plane.
CONCLUSIONS
Significant variations exist for mean LA wall thickness at different regions which are often targeted during circumferential pulmonary venous ablation (CPVA). Appreciating these differences may have significant implications in catheter ablation of AF.
背景
心房颤动（AF）消融的成功率和并发症发生率可能与左心房（LA）壁厚度的区域差异有关。本研究旨在探讨不同部位 LA 壁厚度的透壁变化。
方法
我们使用卡尺在三个平面测量 36 个人类心脏标本的 LA 壁厚度，包括左肺静脉（PV）前庭平面、右 PV 前庭平面和两者之间的中间平面。在每个平面上，选择 8 个点，包括前壁和后壁的上、中、下水平，房顶和底部。
结果
前壁和后壁的厚度从上到下呈梯度变化（前壁：（2.73 ± 1.01）mm、（2.08 ± 0.91）mm 和（1.54 ± 0.69）mm；后壁：（1.74 ± 0.68）mm、（1.48 ± 0.39）mm 和（1.27 ± 0.42）mm）。在房顶，LA 壁厚度在中间平面最厚（（2.01 ± 1.02）mm），在左 PV 前庭平面最薄（（1.29 ± 0.41）mm）。左 PV 前庭平面的后壁厚度比其他两个平面薄（P < 0.05-0.001），且比中间平面薄（P < 0.01-0.001）。而在前壁，左 PV 前庭平面的壁厚度比中间和右 PV 前庭平面厚。
结论
在进行环形肺静脉消融（CPVA）时，不同部位 LA 壁厚度存在明显差异。了解这些差异可能对 AF 的导管消融具有重要意义。
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