Value of Left Atrial Reverse Remodeling and Left Atrial Appendage Function after Pulmonary Vein Isolation for Non-Paroxysmal Atrial Fibrillation Determined as 320-Row Multi-Slice Computed Tomography

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Purpose: The reverse remodeling of left atrium (LA) and the function of LA appendage (LAA) after pulmonary vein isolation (PVI) for Non-paroxysmal atrial fibrillation (NPAF) patients was estimated using 320-row multi-slice computed tomography (MSCT). Methods: We selected the 40 NPAF patients who could examine MSCT before and after PVI. The maximal and minimal left atrial volume (LAV max/LAV min), LA ejection fraction (LAEF), and three parts of LA mechanical function (reservoir volume/conduit volume/booster pomp function), LAA volume and LAA ejection fraction (LAA EF) was calculated by MSCT. All postoperative MSCT studies were examined under SR. CT image reconstruction was performed in 10% steps, dividing the R-R interval into 10 phases for each patient with an effective thickness of 0.5 mm. All the volumes were normalized to the body surface area (BSA). Results: Among 196±72 days of follow up, 27 patients were free from AF without anti-arrhythmic drug (SR group) and others 13 patients recurred AF (REC group). Preoperative data was no difference between two groups. SR group was favorable percent reduction in LA and LAA volume and improvement in all LA function except for LA reservoir volume and LAA EF as compared with REC group. (all p value <0.04, respectively) Conclusions: The certain maintenance of SR for NPAF patients was more effective for both contraction and compliance of LA and LAA, and helped to advance left atrial reverse remodeling.