Hauser Thomas H, Peters Dana C, Wylie Matteo V, Lau Catherine, Josephson Mark E, Manning Warren J
Harvard-Thorndike Laboratory of the Departments of Medicine and.
Yale University Medical School, New Haven, CT, Department of Medicine.
J Atr Fibrillation. 2013 Apr 6;5(6):788. doi: 10.4022/jafib.788. eCollection 2013 Apr-May.
Radiofrequency (RF) ablation procedures to electrically isolate the pulmonary veins (PV) from the left atrium are frequently used to treat atrial fibrillation. We hypothesized that changes in PV size after RF ablation would correlate with the volume of ostial PV scar as assessed by high resolution late gadolinium enhancement (LGE) cardiovascular magnetic resonance (CMR). The study cohort included 23 consecutive subjects. Contrast enhanced PV CMR angiography and LGE were obtained before and 42 ± 18 days after RF ablation. A total of 85 PV were analyzed. Imaging after RF ablation demonstrated a reduction in PV diameter (22 ± 7 mm to 21 ± 6 mm, p = 0.001) and a reduction in cross-sectional area (CSA) (285 ± 141 to 246 ± 110, p < 0.001). There was a significant correlation of PV ostial normalized scar volume with the change in PV diameter (r =-0.21, p =0.049) and CSA (r =-0.28, p =0.010) after AF ablation. PV in the highest quartile for PV scar had the greatest reduction in diameter and CSA (p <0.05 for both). PV size decreases significantly after RF ablation for the treatment of AF. The change in PV size is linearly related to the quantity of LGE scar at the PV ostium.
通过射频（RF）消融术将肺静脉（PV）与左心房进行电隔离常用于治疗心房颤动。我们推测，射频消融术后肺静脉大小的变化与通过高分辨率延迟钆增强（LGE）心血管磁共振（CMR）评估的肺静脉口部瘢痕体积相关。研究队列包括23名连续入选的受试者。在射频消融术前及术后42±18天进行对比增强肺静脉CMR血管造影和LGE检查。共分析了85条肺静脉。射频消融术后的影像显示肺静脉直径减小（从22±7mm降至21±6mm，p=0.001），横截面积（CSA）减小（从285±141降至246±110，p<0.001）。房颤消融术后，肺静脉口部标准化瘢痕体积与肺静脉直径变化（r=-0.21，p=0.049）及CSA变化（r=-0.28，p=0.010）显著相关。肺静脉瘢痕处于最高四分位数的肺静脉直径和CSA减小最为明显（两者p均<0.05）。射频消融治疗房颤后肺静脉大小显著减小。肺静脉大小的变化与肺静脉口部LGE瘢痕量呈线性相关。
