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Importance of Left Atrial Imaging in Catheter Ablation of Atrial Fibrillation

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Cardiac Arrhythmias

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Abstract

Isolation of pulmonary veins (PV) has become a major part of catheter ablation for patients with atrial fibrillation (AF). Pre-procedural information on the variable anatomy of the left atrium (LA) is important in proper planning of AF ablation. Multi-detector computed tomography (MDCT) or magnetic resonance imaging (MRI) can visualize anatomy of PV–LA junction, as well as impeditive endocardial structures such as ridge, cord-like structure, and diverticulum. Also, MDCT can disclose the anatomic relationship between the LA and neighboring vessels which not only cause incomplete ablation block by reducing conductive heating but also can be injured during the procedure. In this manner, MDCT/MRI contributes to successful ablation procedure, reduction of fluoroscopic and procedural time, and prevention of unexpected complications. Several adjuvant ablation procedures to improve outcomes of PV isolation require detailed information on the anatomic variations of the entire LA, and the importance of pre-procedural MDCT/MR is more emphasized. Recently, MDCT/MR images are integrated with electroanatomic mapping systems to improve the outcomes of AF ablation.

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Abbreviations

AF:

Atrial fibrillation

CFAE:

Complex fragmented atrial electrogram

CS:

Coronary sinus

EAM:

Electroanatomic mapping

LA:

Left atrium

LAA:

Left atrial appendage

LCx:

Left circumflex coronary artery

LIPV:

Left inferior pulmonary vein

LSPV:

Left superior pulmonary vein

MDCT:

Multi-detector computed tomography

MRI:

Magnetic resonance imaging

PV:

Pulmonary vein

SNA:

Sinus nodal artery

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Authors and Affiliations

  1. Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea

    Seil Oh MD, PhD, FHRS, Youngjin Cho MD & Eue-Keun Choi MD, PhD

Authors
  1. Seil Oh MD, PhD, FHRS
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  2. Youngjin Cho MD
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  3. Eue-Keun Choi MD, PhD
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Corresponding author

Correspondence to Seil Oh MD, PhD, FHRS .

Editor information

Editors and Affiliations

  1. Department of Cardiology, Center Hospitalier Coutances, Coutances, France

    Ambrose S. Kibos

  2. Department of Internal Medicine Division of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA

    Bradley P. Knight

  3. Division of Cardiology, McGill University Health Center, Montreal, Québec, Canada

    Vidal Essebag

  4. Department of Cardiology, Miami Children's Hospital, Miami, Florida, USA

    Steven B. Fishberger

  5. School of Biology, Chemistry and Health, Manchester Metropolitan University, Manchester, United Kingdom

    Mark Slevin

  6. “Acad. Vasile Candea” Emergency Clinical Center for Cardiovascular Diseases, “Carol Davila” University of Medicine and Pharmacy, “Titu Maiorescu” University Faculty of Medicine,, Bucharest, Romania

    Ion C. Țintoiu

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Oh, S., Cho, Y., Choi, EK. (2014). Importance of Left Atrial Imaging in Catheter Ablation of Atrial Fibrillation. In: Kibos, A., Knight, B., Essebag, V., Fishberger, S., Slevin, M., Țintoiu, I. (eds) Cardiac Arrhythmias. Springer, London. https://doi.org/10.1007/978-1-4471-5316-0_32

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  • DOI: https://doi.org/10.1007/978-1-4471-5316-0_32

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