Characteristics of pulmonary veins and left atrium on computed tomography in patients with atrial fibrillation ablation

Abstract

Background: It is important to evaluate the imaging of the left atrium (LA) and pulmonary veins (PV) before performing catheter ablation of atrial fibrillation. Several factors on computed tomography (CT) are related to the outcome of atrial fibrillation (AF) ablation.
 Methods: From 2/2020 to 5/2022, 45 patients who diagnosed of paroxysmal and persistent atrial fibrillation underwent RF ablation, chest CT scan obtained to evaluate left atrium and pulmonary veins at the Cardiovascular Center – E Hospital.
 Results: The mean age was 56.1±11.8, male/female was 3/1. Paroxysmal atrial fibrillation accounted for 68.9%. PV dimensions: right superior PV was 18.29 ± 2.39 mm and 16.14 ± 2.26 mm; right inferior PV was 17.63 ± 3.74 mm and 15.07 ± 3.82 mm; left superior PV was 18.60 ± 2.55 mm and 15.79 ± 2.43 mm; left inferior PV was 15.25 ± 1.88 mm and 12.08 ± 1.77 mm. The average diameter of LA measured in the superior-inferior, anterior-posteror directions were: 59.97 ± 7.03 mm, 36.70 ± 5.53 mm and 53.64 ± 8.81 m; respectively. The diameter before-after procedure and the procedure time in the group of patients with persistent AF was larger than that of patients with paroxysmal atrial fibrillation (p<0.05). Patients with paroxysmal AF had a higher success rate of ablation than those with persistent AF (OR=5.27, 95%CI: 1.48-18.80, p < 0.05). Patients who met the criteria for large anterior-posterior LA had a lower successful ablation result than patients without large LA (OR=2.04, 95%CI :1.03-4.04, p < 0.05) .
 Conclusion: Detailed left atrial and pulmonary venous imaging is essential when performing atrial fibrillation ablation. Paroxysmaltrial fibrillation has a better ablation outcome than persistent atrial fibrillation. Larger left atrial diameter is associated with a lower success rate of ablation.