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December 22, 2005EP EuropaceOpen Access

Determination of the spatial orientation and shape of pulmonary vein ostia by contrast-enhanced magnetic resonance angiography

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Why the study?

Can contrast-enhanced magnetic resonance angiography (CE-MRA) adequately visualize the spatial orientation and shape of pulmonary vein ostia in patients with atrial fibrillation?

Population

30 consecutive patients with atrial fibrillation prior to ostial ablation

Design

Cross-sectional

Authors

PVPepijn H. van der VoortLeiden UniversityHBH. van den BoschRadboud University NijmegenJPJohannes C. PostÇevre ve Şehircilik Bakanlığı

Discussion

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Implication

CE-MRA reveals PV ostial variability by side and position; hypothesis-generating for ablation planning in AF.

Key Points

  • Assess pulmonary vein (PV) spatial orientation and ostial dimensions using contrast-enhanced magnetic resonance angiography (CE-MRA) prior to catheter ablation in patients with atrial fibrillation.
  • Evaluated 30 consecutive patients with atrial fibrillation who underwent CE-MRA prior to ostial catheter ablation.
  • Used a centre-line technique to define the PV ostium perpendicular to the vein axis and measured minimal and maximal diameters, perimeter, and angles in frontal and transverse planes.
  • Standard four-vein anatomy occurred in 21 patients, while 4 had an accessory right-middle PV and 5 had a common left PV trunk, with left-sided ostia exhibiting smaller, more elliptical dimensions than right-sided ostia.
  • In the transverse plane, superior PVs directed anteriorly (LS -15 ± 13°, RS -13 ± 11°) and inferior PVs directed posteriorly (LI 23 ± 15°, RI 39 ± 15°); in the frontal plane, superior PVs pointed upwards (LS -27 ± 14°, RS -33 ± 12°) while inferior PVs aligned horizontally (LI 2 ± 11°, RI 3 ± 13°).

Structured PICO

Can contrast-enhanced magnetic resonance angiography (CE-MRA) adequately visualize the spatial orientation and shape of pulmonary vein ostia in patients with atrial fibrillation?

P
Population
30 consecutive patients with atrial fibrillation prior to ostial ablation
I
Intervention
Contrast-enhanced magnetic resonance angiography (CE-MRA)
O
Outcome
Pulmonary vein spatial orientation and ostial shape (minimal and maximal ostial diameters, ostial perimeter, and angles in the anatomical frontal and transverse planes)surrogate

CE-MRA can adequately visualize the highly variable shape and spatial orientation of pulmonary vein ostia, providing crucial anatomical information for guiding catheter ablation in atrial fibrillation.

Cite This Study

Voort et al. (2005) studied this question.

synapsesocial.com/papers/6a716e21f44fa9f079df3a64https://doi.org/10.1093/europace/euj006

Topics

Atrial fibrillationPersistent AF managementAF ablation outcomes
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Pulmonary Vein Stenosis After Catheter Ablation of Atrial Fibrillation1998 · 448 citations
  2. 2Assessment of Pulmonary Vein Anatomic Variability by Magnetic Resonance Imaging:2004 · 208 citations
  3. 3Technique and Results of Pulmonary Vein Angiography in Patients Undergoing Catheter Ablation of Atrial Fibrillation2004 · 43 citations
  4. 4Pulmonary Vein Stenosis After Radiofrequency Ablation of Atrial Fibrillation2003 · 360 citations
  5. 5Three‐Dimensional Reconstruction of Pulmonary Veins in Patients with Atrial Fibrillation and Controls:2003 · 49 citations