229-06: Left Atrial Appendage Electrical Isolation for Long-Standing Persistent Atrial Fibrillation: Computational Three-Dimensional Left Atrial Appendage Wall Thickness Maps and Histological Analysis to Guide Ablation
Year: 2016
Type: conference-abstract
Abstract: Purpose of the study: Left atrial appendage (LAA) electrical isolation may improve the efficacy of persistent atrial fibrillation (AF) ablation. We have previously demonstrated substantial acute LAA reconnection rates in both canines and humans following electrical isolation. We sought to establish whether LAA ostial thickness variations could be evaluated by a novel computational algorithm applied to a pre-procedure CT. Methods used: LAA wall thickness was calculated by solving the Laplace equation between the boundary conditions assigned to the endo- and epi-cardial surfaces from CT scans of 20 patients. Comparison was made with acute LAA reconnection sites in 20 patients with longstanding persistent AF undergoing LAA isolation following conventional AF ablation and with ostial LAA thicknesses from a group of cadaveric human hearts without previous ablation matched with the ablation group. Summary of the results: The anterior (2.5 ± 0.8 mm) and superior (2.4 ± 1.2 mm) LAA margins were thickest histologically. This correlated with recorded sites of acute reconnection. The algorithm calculated thicker tissue at the same ostial sites. The thickest region was at the anterior wall; the inferior wall was the thinnest (2.4 ± 1.5 mm vs 1.8 ± 0.8 mm, p = 0.039).
Source: EP Europace
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2600725375