Left atrial wall thickness in paroxysmal atrial fibrillation by multislice-CT is initial marker of structural remodeling and predictor of transition from paroxysmal to chronic form

Left Atrial Wall Thickness and Pulmonary Vein Size are Increased in Patients with Atrial Fibrillation Compared to Healthy Controls - A Multidetector Computed Tomography Study

“…Location 12 covers anatomically the left lateral ridge; a well-known structural complex region often re-ablated [24]. In general LAWT for controls in this study was thinner compared to previous studies [3,14,26]. Yet the control cohorts are characterized by much diversity and size variability.…”

“…We found that AF is associated with a uniformly increased wall thickness in 12 anatomical locations of the left atrial chamber when compared to healthy controls. Previous studies have found differences in LAWT between patients with AF (both persistent and paroxysmal) and controls [3,6,14], but none of them describe a population with healthy matching controls as this.…”

“…Nakamura, et al [14] describe in their study, that patients with paroxysmal AF have significantly increased LAWT (2.4 ± 0.2 mm) compared to subjects with either persistent AF (2.1 ± 0.2 mm) or sinus rhythm (1.9 ± 0.2 mm). Dewland, et al [3] describe oppositely thinner LA walls in patients with AF compared to controls.…”

“…This widely accessible imaging modality may be used to provide a more detailed anatomical evaluation and road map before ablation, in terms of both LA and PV anatomy [3,[7][8][9][10][11][12]. Recent studies indicate that LA and PV characteristics as determined by cardiac MDCT are possible important predictors of AF recurrence after ablation therapy [11,[13][14][15][16], and that the thicker the parts of the LA are, the less successful ablation therapy becomes [13,17]. In addition, it has been found that patients with persistent AF have enlarged LA cavity, decreased left ventricular function and lower success rates than other patients referred for ablation [7,9,18,19].…”

“…No association was found between PV CSA and duration (years of AF), type of AF (paroxysmal or persistent) or type of ablation (firsttime or repeat) ( Table 1, Table 2 We introduce novel information about to what extent the structure of the LA and PV anatomy is altered in AF patients compared to healthy subjects in sinus rhythm. Prior and larger population studies have described LA and PV anatomy in patients with AF [13][14][15][16]28,29].…”