A.A. MALOV¹, S.A. EREMIN²

¹Kazan State Medical University, 49 Butlerov Str., Kazan, Russian Federation, 420012

²Republic Clinical Hospital, 138 Orenburgskiytrakt, Kazan, Russian Federation, 420064

 Malov A.A. — Assistant Lecturer of the Department of Oncology with course of radiology and radiation therapy, e-mail: malov_aleksei@inbox.ru, ORCID ID: 0000-0003-3261-9986

Eremin S.A. — Head of the Department of Surgical Treatment of Complex Cardiac Arrhythmias and Pacing, tel. (843) 237-35-00, e-mail: aritmologia@mail.ru

 Atrial Fibrillation (AF) is characterized by electric activity of atrials with frequency of impulses up to 350-700 a minute and unevenness of the QRS complexes on electrocardiogram (ECG). The morbidity tends to grow, and the assessment of this form of arrhythmia is 3% by 2030. Due to the high frequency of complications of this arrhythmia, special attention is concentrated on studying of morphology and function of the left atrium (LA) at AF. Carrying out reserve and pumping function, LA provides up to 15–30% of stroke output of LV. Violation of the main LA functions in AF is due to hypertrophy, dystrophy and myofibril fibroses. The modern tomographic techniques of MDCT and MRI allow estimating the LA functional and morphological parameters with high accuracy, which is extremely important for evaluation of risk of AF complications, definition of treatment tactics and successful surgical treatment. Assessment of injection fraction (atrial contribution of LA), volume, mouth size, anatomy of pulmonary veins falling into LA and its auricle, and fibrosis of LA myocardium are obligatory conditions of intervention.

The high diagnostic information value of CT and MRI are confirmed by the fact that the sizes of LA and lung veins do not contradict the data of invasive research methods (endocardiac echocardiography and venography), while LA fibrosis is confirmed by the results of histological analyses of biopsies.

Key words: atrial fibrillation (AF), multiple detector computer tomography (MDCT), magnetic resonance tomography (MRI) of heart.

(For citation: Malov A.A., Eremin S.A. Modern tomography methods of morphology and functional assessment of the left atrium at patients with atrial fibrillation. Practical Medicine. 2018)

 REFERENCES

1. Strutynskiy A.V. Ehlektrokardiogramma. Analiz i interpretatsiya [Electrocardiogram. Analysis and interpretation]. Moscow: MEDpress-inform; 2009: 123–224.
2. Stewart S., Hart C.L., Hole D.J., McMurray J.J. Population prevalence, incidence, and predictors of atrial fibrillation in the Renfrew/ Paisley study. Heart, 2001; 86: 516–521.
3. 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS.
4. Calkins H., Kuck K.H., Cappatoand R. oth. Expert consensus document HRS/EHRA/ECAS on catheter and surgical ablation of atrial fibrillation/ HRS/EHRA/ECAS, 2012.
5. Bokeriya L.A., Ivanova Z.Z. Assessment of the morphofunctional characteristics of the left atrium in patients with atrial fibrillation using computer and magnetic resonance imaging. Annaly aritmologii, 2014; 1: no. 4 (in Russ.).
6. Left atrial geometry and outcome of atrialfibrillation ablation: results fromthemulticentre LAGO-AF study. European Heart Journal – Cardiovascular Imaging, (2018) 0, 1–8.
7. Wood M.A., Wittkamp M., Henry D. et al. A comparison of pulmonary vein ostial anatomy by computerized tomography, echocardiography, and venography in patients with atrial fibrillation having radiofrequency catheter ablation. Am. J. Cardiol., 2004; 93: 49–53. DOI: 10.1016/j.amjcard.2003.09.011.
8. Revishvili A.Sh., Lyubkina E.V., Torres Dzh. et al. Results of interventional treatment of various forms of atrial fibrillation. Annaly aritmologii, 2004; 1:86–93 (in Russ.).
9. Romero J., Husain S., Kelesidis I. et al. Detection of left atrial appendage thrombus by cardiac computed tomography in patients with atrial fibrillation: a meta-analysis. Circ:Cardiovasc. Imaging, 2013; 6 (2).
10. Vu Ch.C. The assessment of atrial function by velocity-encoded magnetic resonance imaging. World J. Cardiovasc. Dis., 2013; 3(2): 18–24.
11. Oakes R.S., Badger T.J., Kholmovski E.G. et al. Detection and quantification of left atrial structural remodeling with delayed enhancement magnetic resonance imaging in patients with atrial fibrillation. Circulation, 2009; 119 (13): 1758–67. CIRCULATIONAHA.108.811877.
12. Tsang T.S., Barnes M.E., Bailey K.R. et al. Left atrial volume important risk marker of incident atrial fibrillation in 1655 older men and women. Mayo Clin. Proc., 2001; 76 (5): 467–75.
13. Heist E.K., Refaat M., Danik S.B. et al. Analysis of the left atrial appendage by magnetic resonance angiography in patients with atrial fibrillation. Heart Rhythm., 2006; 3 (11): 1313–8.
14. Jais P., Cauchemez B., Macle L. et al. Catheter ablation versus antiarrhythmic drugs for atrial fibrillation: the A4 study. Circulation, 2008; 118:2498–2505.
15. Hsu L.F., Jais P., Sanders P. et al. Catheter ablation for atrial fibrillation in congestive heart failure. N Engl J Med., 2004; 351: 2373–2383.
16. Khan M.N., Jais P., Cummings J. et al. Pulmonary-vein isolation for atrial fibrillation in patients with heart failure. N Engl J Med., 2008; 359: 1778–1785.