Atrial volume reduction following catheter ablation of atrial fibrillation and relation to reduction in pulmonary vein size

An evaluation using magnetic resonance angiography

Vinod K. Jayam, Jun Dong, Chandrasekhar R. Vasamreddy, Lars Lickfett, Ritsushi Kato, Timm Dickfeld, Zayd Eldadah, Darshan Dalal, David A. Blumke, Ronald D Berger, Henry R Halperin, Hugh Calkins

Research output: Contribution to journalArticle

Abstract

Introduction: Catheter ablation to achieve pulmonary vein (PV) isolation has become an increasingly used treatment strategy for patients with atrial fibrillation (AF). The purpose of this study was to evaluate the impact of segmental isolation of PVs on volume of left atrium and its relation to the decrease in the size of the pulmonary veins. Methods: Gadolinium enhanced Magnetic Resonance Angiography (MRA) was performed in 51 AF patients before and 6 - 8 weeks post PV isolation, using cooled radio-frequency (RF) energy. Three-dimensional reconstruction with maximum intensity projections and multiplanar reformations was performed. Oblique coronal projections were used to measure the ostial size of PVs. Three orthogonal dimensions of LA chamber were measured and computed to assess the volume of the left atrium. Results: The mean LA volume decreased by 15.7% after ablation (p <0.001). The mean PV ostial diameter decreased by 11%, from 18.3 ± 0.8 mm to 16.7 ± 1.0 mm (p = 0.005). Moderate PV stenosis was noted in two veins out of the 192 veins analyzed. There was a significant correlation between changes in the size of PV ostium to that of the LA. Conclusions: Catheter ablation of AF using a segmental PV isolation approach results in a significant reverse remodeling in the left atrium. Significant stenosis of PVs appears to be rare after the segmental isolation procedure.

Original languageEnglish (US)
Pages (from-to)107-114
Number of pages8
JournalJournal of Interventional Cardiac Electrophysiology
Volume13
Issue number2
DOIs
StatePublished - Jul 2005

Fingerprint

Catheter Ablation
Pulmonary Veins
Magnetic Resonance Angiography
Atrial Fibrillation
Heart Atria
Veins
Gadolinium
Radio
Pathologic Constriction

Keywords

  • Atrial fibrillation
  • Catheter ablation
  • Left atrium
  • Magnetic resonance imaging

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Atrial volume reduction following catheter ablation of atrial fibrillation and relation to reduction in pulmonary vein size : An evaluation using magnetic resonance angiography. / Jayam, Vinod K.; Dong, Jun; Vasamreddy, Chandrasekhar R.; Lickfett, Lars; Kato, Ritsushi; Dickfeld, Timm; Eldadah, Zayd; Dalal, Darshan; Blumke, David A.; Berger, Ronald D; Halperin, Henry R; Calkins, Hugh.

In: Journal of Interventional Cardiac Electrophysiology, Vol. 13, No. 2, 07.2005, p. 107-114.

Research output: Contribution to journalArticle

Jayam, Vinod K. ; Dong, Jun ; Vasamreddy, Chandrasekhar R. ; Lickfett, Lars ; Kato, Ritsushi ; Dickfeld, Timm ; Eldadah, Zayd ; Dalal, Darshan ; Blumke, David A. ; Berger, Ronald D ; Halperin, Henry R ; Calkins, Hugh. / Atrial volume reduction following catheter ablation of atrial fibrillation and relation to reduction in pulmonary vein size : An evaluation using magnetic resonance angiography. In: Journal of Interventional Cardiac Electrophysiology. 2005 ; Vol. 13, No. 2. pp. 107-114.
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T2 - An evaluation using magnetic resonance angiography

AU - Jayam, Vinod K.

AU - Dong, Jun

AU - Vasamreddy, Chandrasekhar R.

AU - Lickfett, Lars

AU - Kato, Ritsushi

AU - Dickfeld, Timm

AU - Eldadah, Zayd

AU - Dalal, Darshan

AU - Blumke, David A.

AU - Berger, Ronald D

AU - Halperin, Henry R

AU - Calkins, Hugh

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N2 - Introduction: Catheter ablation to achieve pulmonary vein (PV) isolation has become an increasingly used treatment strategy for patients with atrial fibrillation (AF). The purpose of this study was to evaluate the impact of segmental isolation of PVs on volume of left atrium and its relation to the decrease in the size of the pulmonary veins. Methods: Gadolinium enhanced Magnetic Resonance Angiography (MRA) was performed in 51 AF patients before and 6 - 8 weeks post PV isolation, using cooled radio-frequency (RF) energy. Three-dimensional reconstruction with maximum intensity projections and multiplanar reformations was performed. Oblique coronal projections were used to measure the ostial size of PVs. Three orthogonal dimensions of LA chamber were measured and computed to assess the volume of the left atrium. Results: The mean LA volume decreased by 15.7% after ablation (p <0.001). The mean PV ostial diameter decreased by 11%, from 18.3 ± 0.8 mm to 16.7 ± 1.0 mm (p = 0.005). Moderate PV stenosis was noted in two veins out of the 192 veins analyzed. There was a significant correlation between changes in the size of PV ostium to that of the LA. Conclusions: Catheter ablation of AF using a segmental PV isolation approach results in a significant reverse remodeling in the left atrium. Significant stenosis of PVs appears to be rare after the segmental isolation procedure.

AB - Introduction: Catheter ablation to achieve pulmonary vein (PV) isolation has become an increasingly used treatment strategy for patients with atrial fibrillation (AF). The purpose of this study was to evaluate the impact of segmental isolation of PVs on volume of left atrium and its relation to the decrease in the size of the pulmonary veins. Methods: Gadolinium enhanced Magnetic Resonance Angiography (MRA) was performed in 51 AF patients before and 6 - 8 weeks post PV isolation, using cooled radio-frequency (RF) energy. Three-dimensional reconstruction with maximum intensity projections and multiplanar reformations was performed. Oblique coronal projections were used to measure the ostial size of PVs. Three orthogonal dimensions of LA chamber were measured and computed to assess the volume of the left atrium. Results: The mean LA volume decreased by 15.7% after ablation (p <0.001). The mean PV ostial diameter decreased by 11%, from 18.3 ± 0.8 mm to 16.7 ± 1.0 mm (p = 0.005). Moderate PV stenosis was noted in two veins out of the 192 veins analyzed. There was a significant correlation between changes in the size of PV ostium to that of the LA. Conclusions: Catheter ablation of AF using a segmental PV isolation approach results in a significant reverse remodeling in the left atrium. Significant stenosis of PVs appears to be rare after the segmental isolation procedure.

KW - Atrial fibrillation

KW - Catheter ablation

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