Intracardiac Doppler Echocardiographic Quantification of Pulmonary Vein Flow Velocity: An Effective Technique for Monitoring Pulmonary Vein Ostia Narrowing During Focal Atrial Fibrillation Ablation

Abstract

Ostial ablation for PV isolation may induce a mild-to-moderate increase in PV flow velocity, which can be identified using an ultrasound catheter with Doppler color flow imaging. Increases in PV flow velocity (<158 cm/sec) after a primary ablation procedure appear to be well tolerated, and a return toward baseline flow characteristics should be anticipated by 3 months. A more cautious approach may be required for patients undergoing repeat PV isolation.

Pulmonary Venous Flow Pattern and Atrial Fibrillation: Fact and Controversy

“…Cut-off PVBV for predicting future AF perpetuation is 21.8 cm/sec (sensitivity 84.6%, specificity 78.3%). LAFS is calculated by equation (1) (Ren et al, 2002). PVF monitoring is a practical and cost-effective method for early detection of this serious complication (Tabata et al, 2003;Bollmann 2007).…”

The Future of Cardiac Mapping

“…Phased array ICE imaging uses a 64-element transducer on the distal end of an 8-10 French catheter. These catheters are capable of M-mode, pulsed, continuous wave and color Doppler (Daoud, 2005;Ren et al, 2002;Verma et al, 2002;Ferguson et al, 2009;Kabra & Singh, 2010. ) During intervention, once transseptal access is achieved, ICE facilitates visualization of the left atrial and pulmonary venous anatomy.…”

The Role of Intracardiac Echocardiography in Atrial Fibrillation Ablation

“…10 Peak flow velocity at the pulmonary vein ostium is measured at systole and diastole before and after ablation [ figure 2D]. The ultrasound beam should be within 1 cm of the PV ostium, and the pulsed Doppler sampling gate should be parallel to the PV ostium.…”

“…In our early experience, radiofrequency energy was deployed at a total of 219 PV ostia and changes in PV ostial peak flow velocities and pressure gradients were measured. 10 The peak velocity of PV ostial flow measured 56 ± 12cm/sec (range 21-98) before and 101 ± 22cm/sec …”