External and Endoluminal Analysis of Left Atrial Anatomy and the Pulmonary Veins in Three‐Dimensional Reconstructions of Magnetic Resonance Angiography: The Full Insight from Inside

Schmidt, Boris; Ernst, Sabine; Ouyang, Feifan; Chun, K.R. Julian; Broemel, Thomas; Bänsch, Dietmar; Kück, Karl‐Heinz; Antz, Matthias

doi:10.1111/j.1540-8167.2006.00548.x

Cited by 56 publications

(42 citation statements)

References 39 publications

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“…6 -8 The anatomy of left-sided PVs constitutes a challenge to antral CCL ablation mostly due to the muscular ridge between the PVs and the left atrial appendage that is a narrow (,5 mm) structure in the majority of patients, containing thick myocardium especially in its superior part. 9,10 Accordingly, the majority of CGs (27 out of 40, 68%) after completion of single left-sided CCLs was located at the anterior ridge ( Figure 1B). The second most common site for residual conduction into the left-sided PVs was the LA roof (9 out of 40, 23%).…”

Section: Discussionmentioning

confidence: 99%

Ipsilateral pulmonary vein isolation performed by a single continuous circular lesion: role of pulmonary vein mapping during ablation

et al. 2011

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AimsComplete pulmonary vein isolation (CPVI) can be achieved by continuous circular lesions (CCL) around the ipsilateral pulmonary veins (PVs) guided by a 3D-mapping system. We investigated whether CPVI can be achieved with a single CCL around the isplilateral PVs without recording PV activity during ablation. Methods and resultsFifty patients with atrial fibrillation underwent ablation of CCLs around ipsilateral PVs guided by 3D mapping. One or two Lasso catheters were placed within the PVs. Lasso tracings were hidden to physicians during ablation. After completion of CCLs, Lasso tracings were evaluated. If PV activation was present, conduction gaps (CGs) were identified and ablated with guidance by the local electrogram and the Lasso catheter(s). In 21 patients (42%), CPVI was achieved after ablation of a single CCL around ipsilateral PVs. Pulmonary vein isolation was achieved in 43 patients (86%) in the right-sided PVs and in 21 patients (42%) in the left-sided PVs. In the remaining patients, there were eight CGs in rightsided CCLs and 40 CGs in left-sided CCLs. Conduction gaps along the left CCLs were found at the ridge between the PV ostia and the left atrial appendage in 27 out of 40 CGs (68%). Mean time from the P-wave onset to the earliest PV potential was 112 + 35 ms in the presence of a CG at the roof, and 166 + 59 ms in patients with CGs at other locations in left-sided CCLs (P , 0.05). ConclusionComplete pulmonary vein isolation is difficult to achieve with a single CCL around ipsilateral PVs without continuous recording of PV activation during ablation.--

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Section: Discussionmentioning

confidence: 99%

Ipsilateral pulmonary vein isolation performed by a single continuous circular lesion: role of pulmonary vein mapping during ablation

et al. 2011

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“…A previous study, which evaluated the distance between the fossa ovalis and each PV using MRI, showed that the mean distance was shortest in the RIPV (20.2 mm) among the 4 PVs. 9 The longitudinal diameter of a fully expanded cryoballoon is approximately 24 mm, which may be inadequately large, especially for patients with ventral orientation of the RIPV because the PV ostium deviates closely to the atrial septum. Although the RSPV shows a ventral orientation in almost all patients, isolation of this PV using a cryoballoon is much easier than for the RIPV.…”

Section: Geographic Parameters Of Ipvs On Ct Imagesmentioning

confidence: 99%

Particular Morphology of Inferior Pulmonary Veins and Difficulty of Cryoballoon Ablation in Patients With Paroxysmal Atrial Fibrillation

Yasuoka

Kurita

Kotake

et al. 2017

Circ J

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“…As previously described, the distance between the fossa ovalis and anterior inferior border of the RPVs is short. 15 To allow RN to this region, a rather anterior transseptal puncture site (medial quarter of the fossa ovalis) is advisable.…”

Section: Navigation Propertiesmentioning

confidence: 99%

Remote Robotic Navigation and Electroanatomical Mapping for Ablation of Atrial Fibrillation

Schmidt

Tilz

Neven

et al. 2009

Circ: Arrhythmia and Electrophysiology

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Background-Radiofrequency current ablation of atrial fibrillation (AF) requires high technical skills to achieve optimal catheter stability and is associated with an individually high x-ray exposure to both the patient and the operator. To facilitate catheter navigation and to reduce the operator's x-ray burden, remote navigation (RN) systems have been developed. Considerations for navigation of a novel remote robotic navigation system in pulmonary vein isolation (PVI) procedures are reported. Methods and Results-In 65 patients with drug-refractory AF (43 paroxysmal, 22 persistent), complete circumferential PVI was performed using RN in conjunction with different electroanatomic mapping systems. Acute complete PVI using exclusively RN was achieved in 95%. The procedure time was 195Ϯ40 minutes. The operator's x-ray exposure time was reduced by 6Ϯ4 minutes (35%) using RN. In 7 of 14 patients with persistent AF, conversion to sinus rhythm was achieved by radiofrequency current ablation. During a median follow-up period of 239 days (range, 184 to 314 days), 47 of 65 patients (73%) remained free of any documented atrial tachyarrhythmia recurrences after a single procedure. The relative proportion of patients remaining free of AF was 76% and 68% for paroxysmal and persistent AF, respectively. Conclusions-PVI using the novel RN system can be performed safely and effectively. One third of the operator's fluoroscopy exposure time might be saved using RN. However, the questions of whether the overall fluoroscopy exposure is reduced by RN and whether RN improves PVI procedures needs to be assessed during a comparative trial between man and machine. (Circ Arrhythmia Electrophysiol. 2009;2:120-128.)

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External and Endoluminal Analysis of Left Atrial Anatomy and the Pulmonary Veins in Three‐Dimensional Reconstructions of Magnetic Resonance Angiography: The Full Insight from Inside

Cited by 56 publications

References 39 publications

Ipsilateral pulmonary vein isolation performed by a single continuous circular lesion: role of pulmonary vein mapping during ablation

Ipsilateral pulmonary vein isolation performed by a single continuous circular lesion: role of pulmonary vein mapping during ablation

Particular Morphology of Inferior Pulmonary Veins and Difficulty of Cryoballoon Ablation in Patients With Paroxysmal Atrial Fibrillation

Remote Robotic Navigation and Electroanatomical Mapping for Ablation of Atrial Fibrillation

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