Left atrial volume calculated by multi-detector computed tomography may predict successful pulmonary vein isolation in catheter ablation of atrial fibrillation

Abecasis, João; Dourado, Raquel; Ferreira, António Miguel; Saraiva, Carla; Cavaco, Diogo; Santos, Katya Reis; Morgado, F; Adragão, Pedro; Silva, Aniceto

doi:10.1093/europace/eup198

Cited by 144 publications

(91 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…328,329,365, 1050,1115,1116,1117 Factors that have been identified as predictors of a poorer outcome, at least in some studies, include (1) non-PAF and particularly long-term persistent AF; (2) sleep apnea and obesity; (3) increased LA size; (4) increased age; (5) hypertension; and (6) LA fibrosis as detected by cardiac MRI. 365 …”

Section: Outcomes Of Af Ablation In Populations Not Well Represented mentioning

confidence: 99%

2012 HRS/EHRA/ECAS Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation: Recommendations for Patient Selection, Procedural Techniques, Patient Management and Follow-up, Definitions, Endpoints, and Research Trial Design

Calkins,

Kuck,

Cappato

et al. 2012

Heart Rhythm

1,754

1,468

View full text Add to dashboard Cite

Section: Outcomes Of Af Ablation In Populations Not Well Represented mentioning

confidence: 99%

2012 HRS/EHRA/ECAS Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation: Recommendations for Patient Selection, Procedural Techniques, Patient Management and Follow-up, Definitions, Endpoints, and Research Trial Design

Calkins,

Kuck,

Cappato

et al. 2012

Heart Rhythm

1,754

1,468

View full text Add to dashboard Cite

“…Yet it has been reported that these clinical risk factors are not sufficiently predictive of the treatment success of ablation procedures, which is suggestive of more complex interactions (7). In addition, several studies demonstrated that the echocardiographically the prediction of PVI success (7,12). CMR imaging offers the additional advantage of functional evaluation of the left atrium allowing for the assessment of volume-time curves with accurate determination of diastolic and systolic volumes.…”

Section: Discussionmentioning

confidence: 99%

Cardiovascular magnetic resonance imaging for accurate sizing of the left atrium: Predictability of pulmonary vein isolation success in patients with atrial fibrillation

Jahnke

Fischer²,

Mirelis³

et al. 2011

Magnetic Resonance Imaging

View full text Add to dashboard Cite

Purpose: To prospectively determine the most reproducible approach for left-atrial size assessment using cardiovascular magnetic resonance (CMR) imaging in patients with atrial fibrillation and its value for prediction of pulmonary vein isolation (PVI) treatment success. Materials and Methods:Eighty patients underwent CMR imaging prior to PVI; the CMR examination included standard cine sequences, a multislice cine sequence in 4-chamber orientation with full left-atrial coverage, and a contrast-enhanced MR angiography of the left atrium. Leftatrial size was determined as: diameter, area, volume segmented from angiography, and diastolic/systolic volumes from cine imaging (Simpson's rule). All measurements were carried out by two independent observers and repeated by one observer to assess inter-and intrareader variability. Treatment success was defined as persisting sinus rhythm after PVI (follow-up period 12.6 6 6.6 months).Results: All left-atrial measurements showed substantial intrareader agreement. Interreader agreement was substantial for diastolic/systolic left-atrial volumes only. Calculated bias was found to be minimal (0.1%-4.9%). Predictability of PVI treatment success was best using cine volumetric measurements (cutoff value for diastolic volume, 112 mL) yielding a sensitivity and specificity of 80% and 70%, respectively.Conclusion: Left-atrial volumetry based on cine imaging represented the most reproducible approach to determine left-atrial size. PVI success was predicted best using cine volumetry. ATRIAL FIBRILLATION represents the most common sustained arrhythmia and is associated with a limited quality of life, an increased mortality, and relevant healthcare costs (1,2). During the last years, pulmonary vein isolation (PVI) by radiofrequency percutaneous catheter ablation has proved to be an important therapeutic alternative in patients with symptomatic atrial fibrillation (1,3). The reported success rates of ablation procedures differ widely depending on the selection criteria of the study population (4,5). The leftatrial (LA) size is known to play an important role for procedure planning, performance, and outcome (6,7) and, thus, a standardized imaging approach for the accurate and reproducible assessment of LA size is needed. Currently, transthoracic echocardiography is the most commonly used method for initial determination of LA size and during follow-up examinations, as it is noninvasive and widely available. However, visualization of the left atrium by routinely performed transthoracic echocardiography is limited to one-or twodimensional measurements, resulting in an insufficient estimate of LA size, particularly in case of asymmetric LA dilatation. Cardiovascular magnetic resonance (CMR) imaging is increasingly gaining importance since it allows 3D visualization of all cardiac cavities with a consistently high endocardial border delineation. However, the accurate determination of LA size, especially in patients with atrial fibrillation, is challenging for CMR imaging since varying RR inter...

show abstract

“…Recent studies indicate that LA and PV characteristics as determined by cardiac MDCT are possible important predictors of AF recurrence after ablation therapy [11,[13][14][15][16], and that the thicker the parts of the LA are, the less successful ablation therapy becomes [13,17]. In addition, it has been found that patients with persistent AF have enlarged LA cavity, decreased left ventricular function and lower success rates than other patients referred for ablation [7,9,18,19].…”

Section: Left Atrial Wall Thickness (Lawt)mentioning

confidence: 99%

Left Atrial Wall Thickness and Pulmonary Vein Size are Increased in Patients with Atrial Fibrillation Compared to Healthy Controls - A Multidetector Computed Tomography Study

Thomsen¹

2017

Int J Clin Cardiol

View full text Add to dashboard Cite

Left atrial volume calculated by multi-detector computed tomography may predict successful pulmonary vein isolation in catheter ablation of atrial fibrillation

Abstract: Left atrium volume estimated by MDCT may be useful to identify pts in whom successful AF ablation can be achieved with simpler ablation procedures, restricted to PV isolation.

Cited by 144 publications

References 16 publications

2012 HRS/EHRA/ECAS Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation: Recommendations for Patient Selection, Procedural Techniques, Patient Management and Follow-up, Definitions, Endpoints, and Research Trial Design

2012 HRS/EHRA/ECAS Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation: Recommendations for Patient Selection, Procedural Techniques, Patient Management and Follow-up, Definitions, Endpoints, and Research Trial Design

Cardiovascular magnetic resonance imaging for accurate sizing of the left atrium: Predictability of pulmonary vein isolation success in patients with atrial fibrillation

Left Atrial Wall Thickness and Pulmonary Vein Size are Increased in Patients with Atrial Fibrillation Compared to Healthy Controls - A Multidetector Computed Tomography Study

Contact Info

Product

Resources

About