Left atrial wall thickness: anatomic aspects relevant to catheter ablation of atrial fibrillation.
Left atrial wall thickness: anatomic aspects relevant to catheter ablation of atrial fibrillation.
复制标题
左心房壁厚度：与房颤导管消融相关的解剖学方面。
作者：
Hong;Xin;Hai;Li Zhou;Jia;Xu Liu
背景
房颤消融的成功率和并发症的发生率可能与左房(LA)壁厚度的区域性差异有关。本研究的目的是调查不同区域的跨壁LA壁厚度。
方法
用卡尺在左肺静脉前庭平面、右肺静脉前庭平面和两者之间的中间平面测量了36例人心脏标本的左房壁厚度。在每个平面上选择8个点，包括前、后壁、顶和底的上、中、下水平。
结果
前壁和后壁厚度由高到低依次为(2.73±1.01)mm、(2.08±0.91)mm和(1.54±0.69)mm；后壁：(1.74±0.68)mm、(1.48±0.39)mm和(1.27±0.42)mm。房顶中面左房壁厚度最厚(2.01±1.02)mm，左室前庭面最薄(1.29±0.41)mm。左前庭面后壁厚度较其他两个平面薄(P<0.05~0.001)，右前庭平面较中平面薄(P<0.01~0.001)。而在前壁，左室室前庭面的壁厚大于右室室前庭面和中室壁的厚度。
结论
在环肺静脉消融术(CPVA)中，不同区域的平均LA壁厚度存在显着差异，通常是靶点。认识到这些差异可能对房颤的导管消融有重要意义。
BACKGROUND
The success and complication rates of atrial fibrillation (AF) ablation may be related to regional differences in left atrial (LA) wall thickness. The purpose of this study was to investigate the transmural LA wall thickness in various regions.
METHODS
We measured LA wall thickness in 36 human heart specimens using calipers at three planes including left pulmonary veins (PVs) vestibule plane, right PVs vestibule plane and the middle plane between the two. In each plane, eight points were selected, including superior, middle and inferior levels at anterior and posterior wall, roof and bottom.
RESULTS
The anterior and posterior wall thickness displayed gradient from superior to inferior level (anterior wall: (2.73 ± 1.01) mm, (2.08 ± 0.91) mm and (1.54 ± 0.69) mm; posterior wall: (1.74 ± 0.68) mm, (1.48 ± 0.39) mm and (1.27 ± 0.42) mm). At the roof, LA wall thickness was thickest in middle plane ((2.01 ± 1.02) mm) and was thinnest in left PVs vestibule plane ((1.29 ± 0.41) mm). The posterior wall thickness in left PVs vestibule plane was thinner than in the other two planes (P < 0.05 - 0.001), and was thinner in right PVs vestibule plane than in middle plane (P < 0.01 - 0.001). Whereas in anterior wall, the wall thickness in left PVs vestibule plane was thicker than in middle and right PVs vestibule plane.
CONCLUSIONS
Significant variations exist for mean LA wall thickness at different regions which are often targeted during circumferential pulmonary venous ablation (CPVA). Appreciating these differences may have significant implications in catheter ablation of AF.