Is there an association between left atrial outpouching structures and recurrence of atrial fibrillation after catheter ablation?

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  • Additional Information
    • Source:
      Publisher: Public Library of Science Country of Publication: United States NLM ID: 101285081 Publication Model: eCollection Cited Medium: Internet ISSN: 1932-6203 (Electronic) Linking ISSN: 19326203 NLM ISO Abbreviation: PLoS One Subsets: MEDLINE
    • Publication Information:
      Original Publication: San Francisco, CA : Public Library of Science
    • Subject Terms:
      Atrial Fibrillation*/etiology ; Atrial Fibrillation*/surgery ; Catheter Ablation*/adverse effects ; Catheter Ablation*/methods ; Pulmonary Veins*/diagnostic imaging ; Pulmonary Veins*/surgery ; Diverticulum*; Humans ; Retrospective Studies ; Recurrence ; Treatment Outcome ; Heart Atria
    • Abstract:
      Objective: The aim of this study was to investigate the impact of left atrial diverticula (LADs), left sided septal pouches (LSSPs) and middle right pulmonary veins (MRPVs) on recurrent atrial fibrillation (rAF) in patients undergoing laser pulmonary vein isolation procedure (PVI).
      Material and Methods: This retrospective study enrolled 139 patients with pre-procedural multiple detector computed tomography (MDCT) imaging and 12 months follow-up examination. LADs, LSSPs and MRPV were identified by two radiologists on a dedicated workstation using multiplanar reconstructions and volume rendering technique. Univariate and bivariate regression analyses with patient demographics and cardiovascular risk factors as covariates were performed to reveal independent factors associated with rAF.
      Results: LADs were recorded in 41 patients (29%), LSSPs in 20 (14%) and MRPVs in 15 (11%). The right anterosuperior wall of the left atrium was the most prevalent location of LADs (68%). rAF occured in 20 patients, thereof, 15 exhibited an outpouching structure of the left atrium (LAD: 9, LSSP: 2 and MRPV: 3). Presence of an LAD (HR: 2.7, 95%CI: 1.0-8.4, p = 0.04) and permanent AF (HR: 4.8, 95%CI: 1.5-16.3, p = 0.01) were independently associated with rAF.
      Conclusions: LAD, LSSP and MRPV were common findings on pre-procedural cardiac computed tomography. LADs were revealed as potential independent risk factor of rAF, which might be considered for treatment planning and post-treatment observation.
      Competing Interests: The authors have declared that no competing interests exist.
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    • Publication Date:
      Date Created: 20221027 Date Completed: 20221031 Latest Revision: 20221031
    • Publication Date:
      20221213
    • Accession Number:
      PMC9612428
    • Accession Number:
      10.1371/journal.pone.0276369
    • Accession Number:
      36301863