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01-06-2005 | Cardiac

Sixteen multidetector row computed tomography of pulmonary veins: 3-months’ follow-up after treatment of paroxysmal atrial fibrillation with cryothermal ablation

Authors: Ružica Maksimović, Marcoen F. Scholten, Filippo Cademartiri, Luc J. Jordaens, Peter M. T. Pattynama

Published in: European Radiology | Issue 6/2005

Abstract

The aim of the study was to assess pulmonary veins (PVs) for the presence of stenosis 3 months after cryothermal ablation (CA) with a new method of electrical isolation of PVs using contrast-enhanced 16 multidetector row computed tomography (MDCT). Twenty four patients with symptomatic atrial fibrillation underwent CA in 46 PVs. MDCT of PVs was performed before the treatment and after 3-months’ follow-up. Following cryoablation, 13/24 (54%) patients showed clinical improvement and had reduced attacks of atrial fibrillation. The dimensions of the treated PVs remained unchanged: the coronal ostial diameter was 19.1±2.4 preprocedural versus 18.6±2.4 mm at follow-up, p>0.05; the ratio of the coronal and axial diameters at the ostium was 1.2±0.2 versus 1.2±0.1, p>0.05, respectively, and the coronal diameter of the proximal 10 mm was 17.1±2.5 mm versus 16.5±2.2 mm, p>0.05, respectively. CA is a promising technique for electrical isolation of PVs that has not been associated with stenosis at the orifice and the proximal 10 mm of the PVs after 3-months’ follow-up. MDCT is a noninvasive, fast and comfortable method for assessment of PVs in a three-dimensional manner prior to ablative treatment and during the follow-up.

Haissaguerre M, Jais P, Shah DC et al (1998) Spontaneous initiation of atrial fibrillation by ectopic beats originating in the pulmonary veins. N Engl J Med 339:659–666CrossRefPubMed

Saad EB, Marrouche FN, Saad CP et al (2003) Pulmonary vein stenosis after catheter ablation of atrial fibrillation: emergence of a new clinical syndrome. Ann Intern Med 138:634–638

Ravenel JG, McAdams HP (2002) Pulmonary venous infarction after radiofrequency ablation for atrial fibrillation. Am J Roentgenol 178:664–666

Rodriguez LM, Geller JC, Tse HF et al (2002) Acute results of transvenous cryoablation of supraventricular tachycardia (atrial fibrillation, atrial flutter, Wolff–Parkinson–White syndrome, atrioventricular nodal reentry tachycardia). J Cardiovasc Electrophysiol 13:1082–1089CrossRef

Keane D (2002) New catheter ablation techniques for the treatment of cardiac arrhythmias. Card Electrophysiol Rev 6:341–348CrossRef

Cox J, Holman W, Cain W (1987) Cryosurgical treatment of atrioventricular node re-entrant tachycardia. Circulation 76(6):1329–1336

Wong T, Markides V, Peters NS, Davies D (2004) Percutaneous pulmonary vein cryoablation to treat atrial fibrillation. J Interv Card Electrophysiol 11(2):117–126CrossRef

Tse HF, Reek S, Timmermans C et al (2003) Pulmonary vein isolation using transvenous catheter cryoablation for treatment of atrial fibrillation without risk of pulmonary vein stenosis. J Am Coll Cardiol 42(4):752–758CrossRef

Wittkampf FH, Wever EF, Derksen R et al (1999) LocaLisa: new technique for real-time 3-dimensional localization of regular intracardiac electrodes. Circulation 99:1312–1317

10.

Szili-Torok T, Kimman G, Theuns D, Res J, Roelandt JR, Jordaens LH (2001) Transseptal left heart catheterization guided by intracardiac echocardiography. Heart 86:E11CrossRef

11.

Kalender W, Schmidt B, Zankl M, Schmidt M (1999) A PC program for estimating organ and effective dose values in computed tomography. Eur Radiol 9(3):555–562CrossRefPubMed

12.

Feld GK, Yao B, Reu G, Kudaravalli R (2003) Acute and chronic effects of cryoablation of the pulmonary veins in the dog as a potential treatment for focal atrial fibrillation. J Interv Card Electrophysiol 8:135–140CrossRef

13.

Timmermans C, Rodriguez LM, Van Suylen RJ et al (2002) Catheter-based cryoablation produces permanent bidirectional cavotricuspid isthmus conduction block in dogs. J Interv Card Electrophysiol 7(2):149–155CrossRef

14.

Ho SY, Sanchez-Quintana D, Cabrera JA, Anderson RH (1999) Anatomy of the left atrium: implications for radiofrequency ablation of atrial fibrillation. J Cardiovasc Electrophysiol 10(11):1525–1533PubMed

15.

Yu WC, Hsu TL, Tai CT et al (2001) Acquired pulmonary vein stenosis after radiofrequency catheter ablation of paroxysmal atrial fibrillation. J Cardiovasc Electrophysiol 12(8):887–892CrossRef

16.

Cirillo S, Bonamini R, Gaita F et al (2004) Magnetic resonance angiography virtual endoscopy in the assessment of pulmonary veins before radiofrequency ablation procedures for atrial fibrillation. Eur Radiol 14(11):2053–2060CrossRef

17.

Maksimović R, Cademartiri F, Scholten MF, Jordaens LJ, Pattynama PMT (2004) 16-row multislice computed tomography in the assessment of pulmonary veins prior to ablative treatment: validation versus conventional pulmonary venography and study of reproducibility. Eur Radiol 14(3):369–374. DOI 10.1007/s00330-003-2156-5CrossRefPubMed

18.

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 107:2004–2010CrossRefPubMed

Title: Sixteen multidetector row computed tomography of pulmonary veins: 3-months’ follow-up after treatment of paroxysmal atrial fibrillation with cryothermal ablation
Authors: Ružica Maksimović
Marcoen F. Scholten
Filippo Cademartiri
Luc J. Jordaens
Peter M. T. Pattynama
Publication date: 01-06-2005
Publisher: Springer-Verlag
Published in: European Radiology / Issue 6/2005
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-005-2696-y

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Sixteen multidetector row computed tomography of pulmonary veins: 3-months’ follow-up after treatment of paroxysmal atrial fibrillation with cryothermal ablation

Abstract

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