Interatrial septal thickness is associated with the extent of left atrial complex fractionated atrial electrograms and acute procedural outcome in patients with persistent atrial fibrillation

Yae Min Park, Hwan Cheol Park, Ji Eun Ban, Jongil Choi, Hong Euy Lim, Sang Weon Park, Young Hoon Kim

Research output: Contribution to journalArticlepeer-review

9 Citations (Scopus)

Abstract

Aims: The interatrial septal thickness (IAST) reflects the changes of the atrial wall in patients with atrial fibrillation (AF). Complex fractionated atrial electrograms (CFAEs) were consistently positioned on the interatrial septum, especially in the remodelled left atrium (LA). We sought to characterize the relationship between IAST and LA CFAE area, as well as the acute procedural and clinical outcomes of catheter ablation in persistent AF patients. Methods and results: This study included 71 patients who underwent catheter ablation for drug-refractory persistent AF. A stepwise ablation approach included circumferential pulmonary vein isolation followed by LA and right atrial CFAE-guided ablation. Interatrial septal thickness was measured 1 cm inferior to the fossa ovalis on cardiac computed tomography (CT). The extent of LA CFAEs was assessed by CFAE area and index (CFAE area/LA surface area × 100). Patients were grouped into tertiles according to the value of IAST. The mean IAST of the first, second, and third tertile was 4.69 ± 0.79, 6.44 ± 0.45, and 9.12 ± 1.42 mm, respectively (P < 0.001). The mean CFAE areas (5.6 ± 6.9, 18.5 ± 20.3, and 24.3 ± 26.6 mm2, P = 0.005) and CFAE indexes (3.1 ± 4.2, 9.2 ± 10.7, and 11.8 ± 15.3, P = 0.025) in LA were significantly different among the three groups. More patients in the highest IAST tertile did not terminate AF during catheter ablation (12.5% vs. 26.1% vs. 37.5%, P = 0.048). Conclusions: Interatrial septal thickness measured by cardiac CT is associated with the extent of CFAE area within the LA and is related to acute procedural success of catheter ablation. These findings suggest that IAST reflects the degree of atrial substrate and remodelling in patients with persistent AF.

Original languageEnglish
Pages (from-to)1700-1707
Number of pages8
JournalEuropace
Volume17
Issue number11
DOIs
Publication statusPublished - 2015 Sep 28

Keywords

  • Atrial fibrillation
  • Complex fractionated atrial electrograms
  • Interatrial septal thickness

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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