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Interatrial septal thickness is associated with the extent of left atrial complex fractionated atrial electrograms and acute procedural outcome in patients with persistent atrial fibrillation

Title
Interatrial septal thickness is associated with the extent of left atrial complex fractionated atrial electrograms and acute procedural outcome in patients with persistent atrial fibrillation
Author
박환철
Keywords
Interatrial septal thickness; Complex fractionated atrial electrograms; Atrial fibrillation
Issue Date
2015-11
Publisher
OXFORD UNIV PRESS
Citation
EUROPACE, v. 17, NO 11, Page. 1700-1707
Abstract
The interatrial septal thickness (IAST) reflects the changes of the atrial wall in patients with atrial fibrillation (AF). Complex fractionated atrial electrograms (CFAEs) were consistently positioned on the interatrial septum, especially in the remodelled left atrium (LA). We sought to characterize the relationship between IAST and LA CFAE area, as well as the acute procedural and clinical outcomes of catheter ablation in persistent AF patients. This study included 71 patients who underwent catheter ablation for drug-refractory persistent AF. A stepwise ablation approach included circumferential pulmonary vein isolation followed by LA and right atrial CFAE-guided ablation. Interatrial septal thickness was measured 1 cm inferior to the fossa ovalis on cardiac computed tomography (CT). The extent of LA CFAEs was assessed by CFAE area and index (CFAE area/LA surface area x 100). Patients were grouped into tertiles according to the value of IAST. The mean IAST of the first, second, and third tertile was 4.69 +/- 0.79, 6.44 +/- 0.45, and 9.12 +/- 1.42 mm, respectively (P ˂ 0.001). The mean CFAE areas (5.6 +/- 6.9, 18.5 +/- 20.3, and 24.3 +/- 26.6 mm(2), P = 0.005) and CFAE indexes (3.1 +/- 4.2, 9.2 +/- 10.7, and 11.8 +/- 15.3, P = 0.025) in LA were significantly different among the three groups. More patients in the highest IAST tertile did not terminate AF during catheter ablation (12.5% vs. 26.1% vs. 37.5%, P = 0.048). Interatrial septal thickness measured by cardiac CT is associated with the extent of CFAE area within the LA and is related to acute procedural success of catheter ablation. These findings suggest that IAST reflects the degree of atrial substrate and remodelling in patients with persistent AF.
URI
https://academic.oup.com/europace/article-lookup/doi/10.1093/europace/euu403http://hdl.handle.net/20.500.11754/29005
ISSN
1099-5129; 1532-2092
DOI
10.1093/europace/euu403
Appears in Collections:
COLLEGE OF MEDICINE[S](의과대학) > MEDICINE(의학과) > Articles
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