Abstract
Catheter ablation of atrial fibrillation (AF) has become a real therapeutic option for symptomatic patients resistant to or intolerant of antiarrhythmic drugs. Since the first reports of curative catheter ablation a decade ago, several techniques have evolved [1-5]. Despite the fact that these techniques vary significantly, they all have something in common: the predominant target has become the left atrium and pulmonary veins (PVs). Underestimated by many operators, the variability of the anatomy makes the procedure complex and seems to explain most failures and/or complications. The aim of this review is to discuss the importance of imaging techniques for guidance of catheter ablation of AF.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Haïssaguerre M, Shah DC, Jais P et al (2000) Electrophysiological breakthroughs from the left atrium to the pulmonary veins. Circulation 102:2463–2465
Haïssaguerre M, Shah DC, Jais P et al (2000) Mapping-guided ablation of pulmonary veins to cure atrial fibrillation. Am J Cardiol 86(Suppl 1):K9–K19
Pappone C, Rosanio S, Oreto G et al (2000) Circumferential radiofrequency ablation of pulmonary vein ostia: a new anatomic approach for curing atrial fibrillation. Circulation 102:2619–2628
Pappone C, Oreto G, Rosanio S et al (2001) Atrial electroanatomic remodeling after circumferential radiofrequency pulmonary vein ablation: efficacy of an anatomical approach in a large cohort of patients with atrial fibrillation. Circulation 104:2539–2544
Nademanee K, McKenzie J, Kosar E et al (2004) A new approach for catheter ablation of atrial fibrillation: mapping of the electrophysiologic substrate. J Am Coll Cardiol 43:2044–2053
Nathan H, Eliakin M (1966) The junction between the left atrium and the pulmonary veins. Circulation 34:412–422
Ho SY, Sanchez-Quintana D, Cabrera JA et al (1999) Anatomy of the left atrium: implications for radiofrequency ablation of atrial fibrillation. J Cardiovasc Electrophysiol 10:1525–1533
Ho SY, Cabrera JA, Tran VH et al (2001) Architecture of the pulmonary veins: relevance to radiofrequency ablation. Heart 86:265–270
Moubarak JB, Rozwadowski JV, Strzalka CT et al (2000) Pulmonary veins—left atrial junction: anatomic and histological study. Pacing Clin Electrophysiol 23:1836–1838
Lin WS, Prakash VS, Tai CT et al (2000) Pulmonary vein morphology in patients with paroxysmal atrial fibrillation initiated by ectopic beats originating from the pulmonary veins: implications for catheter ablation. Circulation 101:1274–1281
Wittkampf FHM, Vonken EJ, Derksen R et al (2003) Pulmonary vein ostium geometry: analysis by magnetic resonance angiography. Circulation 107:21–23
Vasamreddy CR, Jayam V, Lickfett L et al (2004) Technique and results of pulmonary vein angiography in patients undergoing catheter ablation of atrial fibrillation. J Cardiovasc Electrophysiol 15:21–26
Tsao HM, Yu WC, Cheng HC et al (2001) Pulmonary vein dilation in patients with atrial fibrillation: detection by magnetic resonance imaging. J Cardiovasc Electrophysiol 12:809–813
Dill T, Neumann T, Ekinci O et al (2003) Pulmonary vein diameter reduction after radiofrequency catheter ablation for paroxysmal atrial fibrillation evaluated by contrast-enhanced three-dimensional magnetic resonance imaging. Circulation 107:845–850
Kato R, Lickfett L, Meininger G et al (2003) Pulmonary vein anatomy in patients undergoing catheter ablation of atrial fibrillation: lessons learned by use of magnetic resonance imaging. Circulation 107:2004–2010
Takase B, Nagata M, Matsui T et al (2004) Pulmonary vein dimensions and variation of branching pattern in patients with paroxysmal atrial fibrillation using magnetic resonance angiography. Jpn Heart J 45:81–92
Mansour M, Holmvang G, Sosnovik D et al (2004) Assessment of pulmonary vein anatomic variability by magnetic resonance imaging: implications for catheter ablation techniques for atrial fibrillation. J Cardiovasc Electrophysiol 15:387–393
Mlcochova H, Cihak R, Tintera J et al (2004) Variability of pulmonary veins in patients undergoing ablation of AF. Europace 6(1):80
Scharf C, Sneider M, Case I et al (2003) Anatomy of the pulmonary veins in patients with atrial fibrillation and effects of segmental ostial ablation analyzed by computed tomography. J Cardiovasc Electrophysiol 14:150–155
Schwartzman D, Lacomis J, Wigginton WG (2003) Characterisation of left atrium and distal pulmonary vein morphology using multidimensional computed tomography. J Am Coll Cardiol 16:1349–1357
Marom EM, Herndon JE, Kim YH et al (2004) Variations in pulmonary venous drainage to the left atrium: implications for radiofrequency ablation. Radiology 230:824–829
Cooper JM, Epstein LM (2001) Use of intracardiac echocardiography to guide ablation of atrial fibrillation. Circulation 104:3010–3013
Kalman JM, Fitzpatrick AP, Olgin JE et al (1997) Biophysical characteristics of radiofrequency lesion formation in vivo: dynamics of catheter tip-tissue contact evaluated by intracardiac echocardiography. Am Heart J 133:8–18
Marrouche N, Martin D, Wayni O et al (2003) Phased-array intracardiac echocardiography monitoring during pulmonary vein isolation in patients with atrial fibrillation: impact on outcome and complications. Circulation 107:2710–2716
Ren JF, Marchlinski FE, Callans DJ (2004) Left atrial thrombus associated with ablation for atrial fibrillation: identification with intracardiac echocardiography. J Am Coll Cardiol 43:1861–1867
Saad EB, Rosillo A, Saad CP et al (2003) Pulmonary vein stenosis after radiofrequency ablation of atrial fibrillation: functional characterisation, evolution, and influence of the ablation strategy. Circulation 108:3102–3107
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2005 Springer-Verlag Italia
About this paper
Cite this paper
Kautzner, J., Peichl, P., Mlcochova, H. (2005). The Role of Imaging in Catheter Ablation of Atrial Fibrillation. In: Gulizia, M.M. (eds) Emerging Pathologies in Cardiology. Springer, Milano . https://doi.org/10.1007/88-470-0341-5_15
Download citation
DOI: https://doi.org/10.1007/88-470-0341-5_15
Publisher Name: Springer, Milano
Print ISBN: 978-88-470-0311-8
Online ISBN: 978-88-470-0341-5
eBook Packages: MedicineMedicine (R0)