This Article Figures Only Full Text Full Text (PDF) All Versions of this Article: j.jacc.2006.10.076v1 49/13/1436    most recent Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in Web of Science Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (3) Citing Articles via Google Scholar Google Scholar Articles by Okada, T. Articles by Murohara, T. Search for Related Content PubMed Articles by Okada, T. Articles by Murohara, T.

CLINICAL RESEARCH: HEART RHYTHM DISORDER

Prevalence and Severity of Left Atrial Edema Detected by Electron Beam Tomography Early After Pulmonary Vein Ablation

Taro Okada, MD^_*, Takumi Yamada, MD^,_*, Yoshimasa Murakami, MD^_*, Naoki Yoshida, MD^_*, Yuuichi Ninomiya, MD^_*, Takeshi Shimizu, MD^_*, Junji Toyama, MD^_*, Yukihiko Yoshida, MD, Teruo Ito, MD, Naoya Tsuboi, MD, Takahisa Kondo, MD^||, Yasuya Inden, MD^||, Makoto Hirai, MD^|| and Toyoaki Murohara, MD^||

^_* Division of Cardiology, Aichi Prefectural Cardiovascular and Respiratory Center, Ichinomiya, Japan
Division of Cardiovascular Diseases, University of Alabama at Birmingham, Birmingham, Alabama
Division of Cardiology, Nagoya Dai-ni Red Cross Hospital, Cardiovascular Center, Nagoya, Japan
Division of Cardiology, Chukyo Hospital, Nagoya, Japan
^|| Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.

Manuscript received August 18, 2006; revised manuscript received October 18, 2006, accepted October 30, 2006.

^_* Reprint requests and correspondence: Dr. Takumi Yamada, Division of Cardiovascular Diseases, Cardiac Rhythm Management Laboratory, University of Alabama at Birmingham, VH B147, 1670 University Boulevard, 1530 3rd Avenue South, Birmingham, Alabama 35294-0019. (Email: takumi-y{at}fb4.so-net.ne.jp).

Objectives: The aim of this study was to investigate the prevalence and severity of left atrial (LA) edema after pulmonary vein (PV) ablation and its effect on the cardiac function.

Background: Though extensive LA catheter ablation has been demonstrated to be more effective in curing paroxysmal atrial fibrillation (PAF) than segmental ostial pulmonary vein isolation (S-PVI), it might cause life-threatening complications, including congestive heart failure associated with LA edema.

Methods: Fifty patients underwent S-PVI (Group S) and 27 underwent circumferential PV antrum ablation (Group C) for drug-refractory PAF. Enhanced electron beam tomography (EBT) was performed before, 1 or 2 days after, and 1 month after the PV ablation, and transthoracic ultrasound cardiography (UCG) was performed 1 month after the PV ablation in all patients.

Results: The EBT assessment revealed LA edema immediately after the PV ablation in 47 Group S patients and all Group C patients. The severity of the LA edema, number of radiofrequency applications, and amount of radiofrequency energy delivered during the PV ablation was significantly greater in Group C than in Group S. One month after the PV ablation, in all patients, the EBT assessment revealed that those edematous changes had disappeared, and the UCG assessment showed no reduction in the cardiac function.

Conclusions: Left atrial edema was observed in a large portion of the patients immediately after the PV ablation, and the severity of the LA edema depended on the extent and amount of the radiofrequency energy delivered in the PV ablation. The LA edema soon disappeared naturally and did not reduce the cardiac function.

Abbreviations and Acronyms   CHF = congestive heart failure   EBT = electron beam tomography   EF = ejection fraction   LA = left atrium   MBC = multielectrode basket catheter   PAF = paroxysmal atrial fibrillation   PV = pulmonary vein   PVI = pulmonary vein isolation   RF = radiofrequency   UCG = ultrasound cardiography

This article has been cited by other articles:

				T. Terasawa, E. M. Balk, M. Chung, A. C. Garlitski, A. A. Alsheikh-Ali, J. Lau, and S. Ip Systematic Review: Comparative Effectiveness of Radiofrequency Catheter Ablation for Atrial Fibrillation Ann Intern Med, July 6, 2009; (2009) 0000605-200908040-00131. [Abstract] [Full Text] [PDF]

				D. C. Peters, J. V. Wylie, T. H. Hauser, R. Nezafat, Y. Han, J. J. Woo, J. Taclas, K. V. Kissinger, B. Goddu, M. E. Josephson, et al. Recurrence of atrial fibrillation correlates with the extent of post-procedural late gadolinium enhancement a pilot study. J. Am. Coll. Cardiol. Img., March 1, 2009; 2(3): 308 - 316. [Abstract] [Full Text] [PDF]