Abstract
Complex ablations procedure might greatly benefit of an imaging technique capable of showing the anatomical details of the ‘terrain’ where the ablation takes place, guiding in real time catheter movements and continuously monitoring the catheter-tissue contact points during the energy delivery. Because 3D TEE provides high-resolution 3D images of the anatomy of the posterior structures of the heart (i.e. left and right atrium), at least in theory, this technique may have the potential to become a new, anatomy-driven navigational guide for ablation procedures. In this chapter we illustrate, normal 3D TEE anatomy of right and left atrial structures involved in ablation procedures and their anatomical variants, and then discuss the strengths and limitations of the technique during catheter ablation for typical atrial flutter and atrial fibrillation.
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Suggested Reading
Asirvatham SJ. Correlative anatomy and electrophysiology for the interventional electrophysiologist: right atrial flutter. J Cardiovasc Electrophysiol. 2009;20:113–22.
Cabrera JA, Sanchez-Quintana D, Ho SY, Medina A, Anderson RH. The architecture of atrial musculature between the orifice of the inferior caval vein and the tricuspid valve: the anatomy of the isthmus. J Cardiovasc Electrophysiol. 1998;9:1186–95.
Faletra FF, Ho SY, Auricchio A. Anatomy of right atrial structures by real-time 3D transesophageal echocardiography. JACC Cardiovasc Imaging. 2010;3:966–75.
Faletra FF, Ho SY, Regoli F, Acena M, Auricchio A. Real-time three-dimensional transesophageal echocardiography in imaging key anatomical structures of the left atrium: potential role during atrial fibrillation ablation. Heart. 2013;99:133–42.
Fassini G, Riva S, Chiodelli R, Trevisi N, Berti M, Carbucicchio C, et al. Left mitral isthmus ablation associated with PV isolation: long-term results of a prospective randomized study. J Cardiovasc Electrophysiol. 2005;16:1150–6.
Haissaguerre M, Sanders P, Hocini M, Takahashi Y, Rotter M, Sacher F, et al. Catheter ablation of long-lasting persistent atrial fibrillation: critical structures for termination. J Cardiovasc Electrophysiol. 2005;16:1125–37.
Ho SY, Sanchez-Quintana D. The importance of atrial structure and fibers. Clin Anat. 2009;22:52–63. Jais P, Hocini M, Hsu LF, Sanders P, Scavee C, Weerasooriya R, et al. Technique and results of linear ablation at the mitral isthmus. Circulation. 2004;110:2996–3002.
Ho SY, McCarthy KP, Faletra FF. Anatomy of the left atrium for interventional echocardiography. Eur J Echocardiogr. 2011;12:i11–5.
Kalman JM, Olgin JE, Karch MR, Hamdan M, Lee RJ, Lesh MD. “Cristal tachycardias”: origin of right atrial tachycardias from the crista terminalis identified by intracardiac echocardiography. J Am Coll Cardiol. 1998;31:451–9.
Loukas M, Tubbs RS, Tongson JM, Polepalli S, Curry B, Jordan R, Wagner T. The clinical anatomy of the crista terminalis, pectinate muscles and taenia sagittalis. Ann Anat. 2008;190:81–7.
Regoli F, Faletra FF, Nucifora G, Pasotti E, Moccetti T, Klersy C, Auriccchio A. Feasibility and acute efficacy of radiofrequency ablation of cavotricuspid isthmus-dependent atrial flutter guided by real-time 3D TEE. JACC Cardiovasc Imaging. 2011;4:716–26.
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Pulmonary vein ablation: burning of the RLPV (AVI 5862 kb)
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Faletra, F.F., Perk, G., Pandian, N.G., Nesser, HJ., Kronzon, I. (2014). The Role of 3D TEE in Ablation Procedures. In: Real-Time 3D Interventional Echocardiography. Springer, London. https://doi.org/10.1007/978-1-4471-4745-9_9
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DOI: https://doi.org/10.1007/978-1-4471-4745-9_9
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