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Evaluation of the Pulmonary Veins and Left Atrial Volume using Multidetector Computed Tomography in Patients Undergoing Catheter Ablation for Atrial Fibrillation.

Ito H, Dajani KA - Curr Cardiol Rev (2009)

Bottom Line: Contrast enhanced electrocardiogram-gated multi-detector computed tomography (MDCT) has rapidly evolved over the past few years into an important tool in the diagnosis of coronary atherosclerosis.There is increasing recognition that MDCT is a useful tool to evaluate non-coronary structures, such as cardiac chambers, valves, the coronary sinus and adjacent structures including pulmonary veins.It provides accurate and reliable identification of the pulmonary veins and anatomical relationship between the left atrium and esophagus although the mobile esophagus may limit the value of MDCT to reduce the risk of atrio-esophagus fistula.

View Article: PubMed Central - PubMed

Affiliation: Division of Cardiology, Loyola University Medical Center, Maywood IL-60153, USA.

ABSTRACT
Catheter ablation is an evolving treatment option in patients with atrial fibrillation. Contrast enhanced electrocardiogram-gated multi-detector computed tomography (MDCT) has rapidly evolved over the past few years into an important tool in the diagnosis of coronary atherosclerosis. There is increasing recognition that MDCT is a useful tool to evaluate non-coronary structures, such as cardiac chambers, valves, the coronary sinus and adjacent structures including pulmonary veins. In particular, MDCT is playing an increasingly important role in the evaluation of the left atrium and the pulmonary veins in patients undergoing catheter ablation for atrial fibrillation. It provides accurate and reliable identification of the pulmonary veins and anatomical relationship between the left atrium and esophagus although the mobile esophagus may limit the value of MDCT to reduce the risk of atrio-esophagus fistula. In this article, we will review the evaluation of the left atrium and pulmonary veins using MDCT in patients undergoing catheter ablation of atrial fibrillation.

No MeSH data available.


Related in: MedlinePlus

Measurements of size of pulmonary vein ostium.
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Figure 2: Measurements of size of pulmonary vein ostium.

Mentions: Prospective electrocardiogram (ECG)-gating has been commonly used as a method to evaluate the left atrium and PVs [26]. Construction of 3-D left atrium and PVs model is processed using volume analysis software. Identification of the number and size of the PVs, draining pattern into the left atrium are assessed from the axial source slices. PV ostial diameters defined as the longest distance between two ostial points in the same plane in two orthogonal views are traced manually (Fig. 2). The 3-D images of left atrium can be acquired using different acquisition techniques with MDCT. Prospective ECG-gating acquisition and construction of the images in diastole seem commonly used for LAV measurement [26]. However, the specific gating protocol was not disclosed in most of the previous reports, while there were only a few reports using the retrospective protocol [26-28]. To the best of our knowledge, no study comparing the merits of prospective versus retrospective gating in the evaluation of left atrial volume and function has been published to date.


Evaluation of the Pulmonary Veins and Left Atrial Volume using Multidetector Computed Tomography in Patients Undergoing Catheter Ablation for Atrial Fibrillation.

Ito H, Dajani KA - Curr Cardiol Rev (2009)

Measurements of size of pulmonary vein ostium.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2803283&req=5

Figure 2: Measurements of size of pulmonary vein ostium.
Mentions: Prospective electrocardiogram (ECG)-gating has been commonly used as a method to evaluate the left atrium and PVs [26]. Construction of 3-D left atrium and PVs model is processed using volume analysis software. Identification of the number and size of the PVs, draining pattern into the left atrium are assessed from the axial source slices. PV ostial diameters defined as the longest distance between two ostial points in the same plane in two orthogonal views are traced manually (Fig. 2). The 3-D images of left atrium can be acquired using different acquisition techniques with MDCT. Prospective ECG-gating acquisition and construction of the images in diastole seem commonly used for LAV measurement [26]. However, the specific gating protocol was not disclosed in most of the previous reports, while there were only a few reports using the retrospective protocol [26-28]. To the best of our knowledge, no study comparing the merits of prospective versus retrospective gating in the evaluation of left atrial volume and function has been published to date.

Bottom Line: Contrast enhanced electrocardiogram-gated multi-detector computed tomography (MDCT) has rapidly evolved over the past few years into an important tool in the diagnosis of coronary atherosclerosis.There is increasing recognition that MDCT is a useful tool to evaluate non-coronary structures, such as cardiac chambers, valves, the coronary sinus and adjacent structures including pulmonary veins.It provides accurate and reliable identification of the pulmonary veins and anatomical relationship between the left atrium and esophagus although the mobile esophagus may limit the value of MDCT to reduce the risk of atrio-esophagus fistula.

View Article: PubMed Central - PubMed

Affiliation: Division of Cardiology, Loyola University Medical Center, Maywood IL-60153, USA.

ABSTRACT
Catheter ablation is an evolving treatment option in patients with atrial fibrillation. Contrast enhanced electrocardiogram-gated multi-detector computed tomography (MDCT) has rapidly evolved over the past few years into an important tool in the diagnosis of coronary atherosclerosis. There is increasing recognition that MDCT is a useful tool to evaluate non-coronary structures, such as cardiac chambers, valves, the coronary sinus and adjacent structures including pulmonary veins. In particular, MDCT is playing an increasingly important role in the evaluation of the left atrium and the pulmonary veins in patients undergoing catheter ablation for atrial fibrillation. It provides accurate and reliable identification of the pulmonary veins and anatomical relationship between the left atrium and esophagus although the mobile esophagus may limit the value of MDCT to reduce the risk of atrio-esophagus fistula. In this article, we will review the evaluation of the left atrium and pulmonary veins using MDCT in patients undergoing catheter ablation of atrial fibrillation.

No MeSH data available.


Related in: MedlinePlus