Morphologic Analysis of Left Atrial Anatomy by Magnetic Resonance Angiography in Patients With Atrial Fibrillation: A Large Single Center Experience

Anselmino, Matteo; Blandino, Alessandro; Beninati, Serena; Rovera, Chiara; Boffano, Carlo; Belletti, M.; Caponi, Domenico; Scaglione, Mariano; Cesarani, Federico; Gaïta, Fiorenzo

doi:10.1111/j.1540-8167.2010.01853.x

Cited by 64 publications

(52 citation statements)

References 26 publications

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“…Typical PV anatomy, with four distinct PV ostia, is present in approximately 20% to 60% of subjects [8,[12][13][14][15][16]. Our findings confirm these data: almost half of patients presented an abnormal PV anatomy with the left common trunk being the most common PV anomaly.…”

Section: Discussionsupporting

confidence: 80%

“…Left atriograms acquired were reconstructed with 3-dimensional(3D) segmentation software using CARTO3 (Biosense Webster, DiamondBar,CA). The number and distribution of PVs were recorded for each patient, including the left and right superior PV, the left and right inferior PV, and the presence of PV variations, for example a common left or right trunk, and left-or right-sided accessory PVs [8] (Figure 1). A common trunk was defined as a superior and inferior PV that join proximal to the LA resulting in a single atrio pulmonary venous junction.…”

Section: Introductionmentioning

confidence: 99%

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Effect of left atrial volume and pulmonary vein anatomy on outcome of nMARQ™ catheter ablation of paroxysmal atrial fibrillation

Stabile

Anselmino

Soldati

et al. 2016

J Interv Card Electrophysiol

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Results. Mean LA volume was 75±40 ml. A normal anatomy (4 PVs) was documented in 40 (53%) patients, an abnormal anatomy (common truncus or accessory PVs) in 35 patients. Mean procedural and fluoroscopy times were 94 ± 55 minutes and 8 ± 5 minutes, respectively, without significant differences among patients with normal or abnormal anatomy (92±45 min vs 95±64 min, p=0.85 and 6±3 min vs 8±4 min, p=0.65, respectively).Mean ablation time was 14 3 min, 99% of the targeted veins were isolated with a mean of 23±5 RF pulses per patient. After a mean follow-up of 17±8 months, 23(31%) patients had an atrial arrhythmia recurrence. Neither LA volume nor PV anatomy were predictors of outcome.Conclusions. LA volume and PV anatomy did not effect procedural data and outcome in patients who underwent PV isolation by an open-irrigated mapping and RF decapolar ablation catheter.3

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Section: Discussionsupporting

confidence: 80%

Section: Introductionmentioning

confidence: 99%

Effect of left atrial volume and pulmonary vein anatomy on outcome of nMARQ™ catheter ablation of paroxysmal atrial fibrillation

Stabile

Anselmino

Soldati

et al. 2016

J Interv Card Electrophysiol

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“…Pulmonary vein ostia were defi ned by the signal intensity refl ection between the planes of the left atrium and pulmonary vein. 31 Cross-sectional area was determined by manual edge tracing on the reformatted orthogonal image. Total cross-sectional pulmonary vein area was reported as the sum of all pulmonary veins.…”

Section: Ventricular Assessmentmentioning

confidence: 99%

Impaired Left Ventricular Filling in COPD and Emphysema: Is It the Heart or the Lungs?

Smith

Prince

Hoffman

et al. 2013

Chest

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1143C hronic lower respiratory disease is the third-leading cause of death in the United States. 1 The most morbid components of chronic lower respiratory dis ease are COPD, defi ned by spirometry as airfl ow obstruction that is not fully reversible, and pulmonary emphysema, defi ned by morphology as permanent enlargement of airspaces accompanied by destruction of their walls. 2,3 Emphysema on CT imaging is present in approximately one-half of patients with COPD, 4-7 and an estimated 2% of the general population aged . 50 years has emphysema without spirometry-defi ned COPD. 8 The number of Americans with a diagnosis of heart failure was 5.7 million in 2008, and approximately one-half of prevalent heart failure cases are characterized by preserved ejection fraction. 9,10 By comparison, 12 million Americans have a diagnosis of COPD and an additional 12 million may have undiagnosed COPD and emphysema. 11Background: COPD and heart failure with preserved ejection fraction overlap clinically, and impaired left ventricular (LV) fi lling is commonly reported in COPD. The mechanism underlying these observations is uncertain, but may include upstream pulmonary dysfunction causing low LV preload or intrinsic LV dysfunction causing high LV preload. The objective of this study is to determine if COPD and emphysema are associated with reduced pulmonary vein dimensions suggestive of low LV preload. Methods: The population-based Multi-Ethnic Study of Atherosclerosis (MESA) COPD Study recruited smokers aged 50 to 79 years who were free of clinical cardiovascular disease. COPD was defi ned by spirometry. Percent emphysema was defi ned as regions , 2 910 Hounsfi eld units on full-lung CT scan. Ostial pulmonary vein cross-sectional area was measured by contrast-enhanced cardiac magnetic resonance and expressed as the sum of all pulmonary vein areas. Linear regression was used to adjust for age, sex, race/ethnicity, body size, and smoking. Results: Among 165 participants, the mean ( Ϯ SD) total pulmonary vein area was 558 Ϯ 159 mm 2 in patients with COPD and 623 Ϯ 145 mm 2 in control subjects. Total pulmonary vein area was smaller in patients with COPD ( 2 57 mm 2 ; 95% CI, 2 106 to 2 7 mm 2 ; P 5 .03) and inversely associated with percent emphysema ( P , .001) in fully adjusted models. Signifi cant decrements in total pulmonary vein area were observed among participants with COPD alone, COPD with emphysema on CT scan, and emphysema without spirometrically defi ned COPD. Conclusions: Pulmonary vein dimensions were reduced in COPD and emphysema. These fi ndings support a mechanism of upstream pulmonary causes of underfi lling of the LV in COPD and in patients with emphysema on CT scan. CHEST 2013; 144(4):1143-1151Abbreviations: E/A ratio 5 ratio of peak fi lling rates during early phase diastole and atrial contraction; E/A ratioMR 5 ratio of peak fi lling rates during early phase diastole and atrial contraction estimated by magnetic resonance; EDV 5 end-diastolic volume; LV 5 left ventricle; MESA 5 Multi-Ethnic Study of Atherosclero...

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“…However, the stratification of the patients based on LA size and the complete electrical isolation of PVs avoiding ablation within the ostia that may produce a PVs stenoses are the cornerstone for a high RFCA success rate with low rate of procedural complications [33]. Moreover, a detailed LA pattern anatomy is crucial considering that only 40% of patients have typical pulmonary vein anatomy with four ostia [34]. TTE remains the imaging modality of choice as first test.…”

Section: Discussionmentioning

confidence: 99%

Comparison of cardiac computed tomography versus cardiac magnetic resonance for characterization of left atrium anatomy before radiofrequency catheter ablation of atrial fibrillation

Andreini

Bertella

Petullà

et al. 2015

International Journal of Cardiology

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Morphologic Analysis of Left Atrial Anatomy by Magnetic Resonance Angiography in Patients With Atrial Fibrillation: A Large Single Center Experience

Cited by 64 publications

References 26 publications

Effect of left atrial volume and pulmonary vein anatomy on outcome of nMARQ™ catheter ablation of paroxysmal atrial fibrillation

Effect of left atrial volume and pulmonary vein anatomy on outcome of nMARQ™ catheter ablation of paroxysmal atrial fibrillation

Impaired Left Ventricular Filling in COPD and Emphysema: Is It the Heart or the Lungs?

Comparison of cardiac computed tomography versus cardiac magnetic resonance for characterization of left atrium anatomy before radiofrequency catheter ablation of atrial fibrillation

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