Catheter Ablation -> Atrial Fibrillation & Atrial Flutter: -> Ablation Techniques D-PO02 - Poster Session II (ID 47) Poster

D-PO02-184 - Left Atrial Wall Thickness Evaluation During Atrial Fibrillation ReDo Procedures (ID 1050)

Abstract

Background: Pulmonary vein (PV) reconnections due to gaps on ablation lines are responsible for atrial fibrillation (AF) recurrences. We analyzed the left atrial wall thickness (LAWT) of PV line gaps at AF redo ablation.
Objective: To analyze the relationship between PV line gaps and LAWT during AF redo procedures.
Methods: 41 consecutive patients referred for AF redo procedure were included. LAWT maps were computed from the multidetector computed tomography (MDCT) as the local distance between the LA endo and epicardium. Each PV line was subdivided into 8 segments and mean LAWT was computed. During the procedure, the local gap was defined as the earliest activation site at the reconnected segment of the circumferential PV line (Figure 1A & 1B).
Results: 41 patients [31 (75.6%) male, age 60±10 y]; Mean LAWT was 1.36 ± 0.20 mm. Mean PV line WT was higher in left PVs than in the right PVs 1.68 ± 0.57 vs. 1.31 ± 0.39 mm p<0.001. Mean WT of the reconnected points was 44% higher than the mean WT of the segment where the reconnection was located. Mean reconnection point WT was at the 87th percentile of the circumferential line in the LPVs and at the 76th percentile in the RPVs. The reconnected point WT was higher in the LPVs than RPVs 2.13 ± 1.14 vs. 1.47 ± 0.48 mm p<0.001. The most frequent location for reconnections was the left anterior carina (71%), with a mean WT of 2.24 ± 0.91mm; and the right anterior carina (56%) with a mean WT of 1.57 ± 0.62mm (Figure 2A & 2B).
Conclusion: Reconnection points were more frequently present in the thicker segments of the PV line. The most frequently reconnected segments were the left and right anterior carinas. Atrial wall thickness maps derived from MDCT are useful to guide AF redo procedures.
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