Buffle Eric, Johner Nicolas, Namdar Mehdi, Shah Dipen
Hôpitaux Universitaires de Genève, Service de Cardiologie, Geneva, Switzerland; Inselspital Bern, Universitätsklinik für Kardiologie, Bern, Switzerland.
Hôpitaux Universitaires de Genève, Service de Cardiologie, Geneva, Switzerland.
Indian Heart J. 2022 May-Jun;74(3):260-261. doi: 10.1016/j.ihj.2022.03.007. Epub 2022 Mar 17.
Papathanasiou et al point out that the two different methods of LA volume and diameter measurement in our recent publication could limit the significance of the correlations we reported with PV reconnection and non-PV foci as mechanisms of post AF ablation recurrence. While we acknowledge the lack of statistically significant correlations of smaller echo derived LA diameter with PV reconnection or of a larger angiographic LA volume with non-PV foci, the congruent confidence intervals of this correlation suggest a statistical trend. Non-uniform LA dimensional changes as an expression of structural remodelling may also be a possible explanation. Published data indicates that angiographic LA volumes consistently exhibit a positive bias compared to echocardiographic volumes but do provide intra-procedural measurements better correlating with gold standard techniques like CT or MRI. Finally we agree with Papathanasiou et al that dynamic changes in LA dimensions likely correlate with early and late mechanisms of recurrence and merit prospective studies.
帕帕纳西欧等人指出，在我们最近的出版物中，左心房容积和直径测量的两种不同方法可能会限制我们所报告的与肺静脉重新连接和非肺静脉病灶作为房颤消融术后复发机制的相关性的意义。虽然我们承认较小的超声心动图衍生的左心房直径与肺静脉重新连接之间缺乏统计学上的显著相关性，或者较大的血管造影左心房容积与非肺静脉病灶之间缺乏相关性，但这种相关性的一致置信区间表明存在统计趋势。作为结构重塑表现的左心房尺寸变化不均匀也可能是一种解释。已发表的数据表明，与超声心动图容积相比，血管造影左心房容积始终存在正偏差，但确实提供了与CT或MRI等金标准技术相关性更好的术中测量值。最后，我们同意帕帕纳西欧等人的观点，即左心房尺寸的动态变化可能与复发的早期和晚期机制相关，值得进行前瞻性研究。
