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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

Paintbrush technique to calculate left atrial volume at each slice, excluding pulmonary veins and left atrial appendage.
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Figure 3: Paintbrush technique to calculate left atrial volume at each slice, excluding pulmonary veins and left atrial appendage.

Mentions: We conducted the study analyzing the LAV of 30 patients referred for cardiac MDCT using retrospective gating to see if one phase can accurately be used routinely for maximal LAV. LAV was measured by manually tracing the left atrium in each slice of the CT scan from the level of the mitral annulus to the roof of the left atrium. The left atrial appendage and PVs are excluded at their ostia (Fig. 3). Of a total 30 patients, 17 patients (56.7%) had maximal LAV at 30% phase of the R-R interval, and 23 patients (76.7%) had minimal LAV at 90 % phase (Fig. 4). Compared with retrospective gating method, prospective gating at 60% or 70% of the R-R interval significantly underestimated maximal LAV with a mean difference of 17.5±7.9mL and 17.5±8.8mL, respectively. Minimal LAV and LAEF could only be calculated using retrospective method (Table 1).


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)

Paintbrush technique to calculate left atrial volume at each slice, excluding pulmonary veins and left atrial appendage.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 3: Paintbrush technique to calculate left atrial volume at each slice, excluding pulmonary veins and left atrial appendage.
Mentions: We conducted the study analyzing the LAV of 30 patients referred for cardiac MDCT using retrospective gating to see if one phase can accurately be used routinely for maximal LAV. LAV was measured by manually tracing the left atrium in each slice of the CT scan from the level of the mitral annulus to the roof of the left atrium. The left atrial appendage and PVs are excluded at their ostia (Fig. 3). Of a total 30 patients, 17 patients (56.7%) had maximal LAV at 30% phase of the R-R interval, and 23 patients (76.7%) had minimal LAV at 90 % phase (Fig. 4). Compared with retrospective gating method, prospective gating at 60% or 70% of the R-R interval significantly underestimated maximal LAV with a mean difference of 17.5±7.9mL and 17.5±8.8mL, respectively. Minimal LAV and LAEF could only be calculated using retrospective method (Table 1).

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