Guerrero PC, Vallejo VEP, Ricaño CMM, Fajardo JIA, Soto LME, Nava TSR

Idioma: Español
Referencias bibliográficas: 26
Paginas: 22-28
Archivo PDF: 214.54 Kb.

RESUMEN

Introducción: La fibrilación auricular es la arritmia más común. Las terapias disponibles actualmente tienen una eficacia limitada. Objetivos: Evaluar el índice de esfericidad de la aurícula izquierda como factor de riesgo de recurrencia de la fibrilación auricular después de la ablación de venas pulmonares y determinar las alteraciones estructurales de la aurícula izquierda que se asocien a un mayor riesgo de recurrencia. Material y métodos: En el Centro Médico ABC, entre marzo de 2012 y mayo de 2016, se llevó a cabo un estudio observacional y comparativo de casos y controles. Se incluyeron pacientes con diagnóstico de fibrilación auricular a los cuales se les realizó ablación de las venas pulmonares y tenían tomografía computada de venas pulmonares. Resultados: De un total de 15 pacientes, el éxito de la ablación se estableció en nueve (60%). Al comparar con el grupo control, aquellos con fibrilación auricular presentan un mayor diámetro anteroposterior (27.18 ± 5.18 versus 36.08 ± 5.4, p = 0.0001) y un mayor diámetro septum-lateral (33.45 ± 4.1 versus 40.27 ± 7.78, p = 0.007). Como factores morfológicos asociados a recurrencia se encontró un mayor volumen de la aurícula izquierda (120.59 ± 49.95 versus 66.65 ±11.9), volumen indexado (57.65 ± 19.77 versus 34.09 ± 7.06), diámetro septum-lateral (43.95 ± 7.6 versus 36.07 ± 5.85) y diámetro longitudinal (66.63 ± 8.3 versus 58.81 ± 6.2), con una diferencia estadística de p = 0.02, p = 0.01, p = 0.04, p = 0.05, respectivamente. Conclusiones: En el grupo de pacientes con fibrilación auricular que tienen recurrencia hay un mayor grado de alteraciones estructurales que conducen al remodelado esférico de la aurícula izquierda.

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