Technique and Results of Pulmonary Vein Angiography in Patients Undergoing Catheter Ablation of Atrial Fibrillation

Chandrasekhar R. Vasamreddy, Vinod Jayam, Lars Lickfett, Khurram Nasir, David J. Bradley, Zayd Eldadah, Timm Dickfeld, Kevin Donahue, Henry R Halperin, Ronald D Berger, Hugh Calkins

Research output: Contribution to journalArticle

Abstract

Introduction: Delineation of pulmonary vein (PV) anatomy is an integral part of the PV isolation procedure. The aims of the present study were to (1) describe the technique of selective PV angiography, (2) show the typical fluoroscopic locations and appearance of the PVs, and (3) compare the ostial diameters of PVs measured by angiography and magnetic resonance imaging (MRI). Methods and Results: Twenty consecutive patients undergoing a PV isolation procedure underwent selective PV angiography using a deflectable 8-French lumened catheter (Naviport, Cardima). The left superior PV (LSPV) runs upward and away from the spine in the right anterior oblique (RAO) projection and upward and toward the spine in the left anterior oblique (LAO) projection. The opposite is true for the right superior PV (RSPV). The left inferior PV (LIPV) has a bull's-eye appearance in the RAO projection, and the right inferior PV (RIPV) has a bull's-eye appearance in the LAO projection due to their end-on trajectories. The LIPV in the LAO projection and the RIPV in the RAO projection run horizontally toward the spine. An excellent correlation was noted in PV ostial size as assessed by angiography and MRI (r2 <0.90, P <0.0001). Conclusion: This study describes the technique and results of PV angiography and fluoroscopy. The study also demonstrates good correlation of PV ostial diameters by contrast venography and MRI. PV angiography can be used as an alternate to MRI or computed tomographic imaging, particularly when these tests are unavailable or are contraindicated in the patient.

Original languageEnglish (US)
Pages (from-to)21-26
Number of pages6
JournalJournal of Cardiovascular Electrophysiology
Volume15
Issue number1
DOIs
StatePublished - Jan 2004

Fingerprint

Catheter Ablation
Pulmonary Veins
Atrial Fibrillation
Angiography
Magnetic Resonance Imaging
Spine
Phlebography
Fluoroscopy
Anatomy
Catheters

Keywords

  • Angiography
  • Atrial fibrillation
  • Catheter ablation
  • Magnetic resonance imaging
  • Pulmonary vein

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology

Cite this

Technique and Results of Pulmonary Vein Angiography in Patients Undergoing Catheter Ablation of Atrial Fibrillation. / Vasamreddy, Chandrasekhar R.; Jayam, Vinod; Lickfett, Lars; Nasir, Khurram; Bradley, David J.; Eldadah, Zayd; Dickfeld, Timm; Donahue, Kevin; Halperin, Henry R; Berger, Ronald D; Calkins, Hugh.

In: Journal of Cardiovascular Electrophysiology, Vol. 15, No. 1, 01.2004, p. 21-26.

Research output: Contribution to journalArticle

Vasamreddy, Chandrasekhar R. ; Jayam, Vinod ; Lickfett, Lars ; Nasir, Khurram ; Bradley, David J. ; Eldadah, Zayd ; Dickfeld, Timm ; Donahue, Kevin ; Halperin, Henry R ; Berger, Ronald D ; Calkins, Hugh. / Technique and Results of Pulmonary Vein Angiography in Patients Undergoing Catheter Ablation of Atrial Fibrillation. In: Journal of Cardiovascular Electrophysiology. 2004 ; Vol. 15, No. 1. pp. 21-26.
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T1 - Technique and Results of Pulmonary Vein Angiography in Patients Undergoing Catheter Ablation of Atrial Fibrillation

AU - Vasamreddy, Chandrasekhar R.

AU - Jayam, Vinod

AU - Lickfett, Lars

AU - Nasir, Khurram

AU - Bradley, David J.

AU - Eldadah, Zayd

AU - Dickfeld, Timm

AU - Donahue, Kevin

AU - Halperin, Henry R

AU - Berger, Ronald D

AU - Calkins, Hugh

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N2 - Introduction: Delineation of pulmonary vein (PV) anatomy is an integral part of the PV isolation procedure. The aims of the present study were to (1) describe the technique of selective PV angiography, (2) show the typical fluoroscopic locations and appearance of the PVs, and (3) compare the ostial diameters of PVs measured by angiography and magnetic resonance imaging (MRI). Methods and Results: Twenty consecutive patients undergoing a PV isolation procedure underwent selective PV angiography using a deflectable 8-French lumened catheter (Naviport, Cardima). The left superior PV (LSPV) runs upward and away from the spine in the right anterior oblique (RAO) projection and upward and toward the spine in the left anterior oblique (LAO) projection. The opposite is true for the right superior PV (RSPV). The left inferior PV (LIPV) has a bull's-eye appearance in the RAO projection, and the right inferior PV (RIPV) has a bull's-eye appearance in the LAO projection due to their end-on trajectories. The LIPV in the LAO projection and the RIPV in the RAO projection run horizontally toward the spine. An excellent correlation was noted in PV ostial size as assessed by angiography and MRI (r2 <0.90, P <0.0001). Conclusion: This study describes the technique and results of PV angiography and fluoroscopy. The study also demonstrates good correlation of PV ostial diameters by contrast venography and MRI. PV angiography can be used as an alternate to MRI or computed tomographic imaging, particularly when these tests are unavailable or are contraindicated in the patient.

AB - Introduction: Delineation of pulmonary vein (PV) anatomy is an integral part of the PV isolation procedure. The aims of the present study were to (1) describe the technique of selective PV angiography, (2) show the typical fluoroscopic locations and appearance of the PVs, and (3) compare the ostial diameters of PVs measured by angiography and magnetic resonance imaging (MRI). Methods and Results: Twenty consecutive patients undergoing a PV isolation procedure underwent selective PV angiography using a deflectable 8-French lumened catheter (Naviport, Cardima). The left superior PV (LSPV) runs upward and away from the spine in the right anterior oblique (RAO) projection and upward and toward the spine in the left anterior oblique (LAO) projection. The opposite is true for the right superior PV (RSPV). The left inferior PV (LIPV) has a bull's-eye appearance in the RAO projection, and the right inferior PV (RIPV) has a bull's-eye appearance in the LAO projection due to their end-on trajectories. The LIPV in the LAO projection and the RIPV in the RAO projection run horizontally toward the spine. An excellent correlation was noted in PV ostial size as assessed by angiography and MRI (r2 <0.90, P <0.0001). Conclusion: This study describes the technique and results of PV angiography and fluoroscopy. The study also demonstrates good correlation of PV ostial diameters by contrast venography and MRI. PV angiography can be used as an alternate to MRI or computed tomographic imaging, particularly when these tests are unavailable or are contraindicated in the patient.

KW - Angiography

KW - Atrial fibrillation

KW - Catheter ablation

KW - Magnetic resonance imaging

KW - Pulmonary vein

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