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Pulmonary vein remodeling following pulmonary vein isolation in
patients with atrial fibrillation—do pulmonary veins represent only
an epiphenomenon? A cardiac MRI study

Research Abstract
Background: After successful pulmonary vein isolation (PVI) for atrial fibrillation (AF), the left atrium (LA) undergoes reverse remodeling. However, few studies have directly studied pulmonary vein (PV) remodeling and focused on whether pre PVI-PV conditions could predict outcome of the procedure. We hypothesize that: (I) post PVI, in addition to LA remodeling the PVs undergo a parallel degree of remodeling; and (II) that PV characteristics pre PVI can be used to identify patients more likely to sustain normal sinus rhythm (NSR). Methods: Patients (n=100) scheduled for PVI had a cardiovascular magnetic resonance (CMR) imaging before and 6±2 months following PVI. PV cross sectional areas (CSA) within 0.5 cm of the ostium and LA volumes were measured. Patients were categorized as responders (R) or non-responders (NR), based on two separate 14-day Holter monitoring. Results: PVs CSA were significantly reduced post procedure in both groups, R (233±53 to 192±52 mm2, P0.001) and NR (241±54 to 207±44 mm2, P0.001), however, the difference between R and NR post PVI was not significant (192±52 to 207±44 mm2, P=0.19). Reduction in PVs CSAs post procedure moderately correlated with the 3D LA volume reduction (r=0.48, P0.001). Conclusions: PVs mirror the LA in that they significantly change in size following PVI yet they were not found to directly predict maintenance of NSR.
Research Authors
Shimaa Khidr, Mark Doyle, Geetha Rayarao, Mohamed Abdel Ghany, Hosam Hasan-Ali, Doaa A.
Fouad, William Belden, Robert W. Biederman
Research Department
Research Journal
Cardiovascular diagnosis and therapy
Research Member
Research Pages
NULL
Research Publisher
NULL
Research Rank
1
Research Vol
NULL
Research Website
NULL
Research Year
2018