Complications of pulmonary vein isolation by catheter ablation evaluated by ECG-gated multislice computed tomography

Funabashi, Nobusada; Yonezawa, Masayori; Iesaka, Yoshito; Umekita, Hideo; Yanagawa, Noriyuki; Matsumoto, Yasunori; Yoshida, Katsuya; Komuro, Issei

doi:10.1007/s00380-003-0714-z

Cited by 6 publications

(2 citation statements)

References 10 publications

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“…Often, the cause of the symptoms is elusive, and patients can be unsuccessfully treated for several weeks or months before the diagnosis is made 10 . The diagnosis can be made with a variety of noninvasive imaging modalities, including echocardiography, 5 magnetic resonance angiography, 5,13,14 ventilation/perfusion imaging, 15 and computed tomographic angiography 16 …”

Section: Discussionmentioning

confidence: 99%

Lobectomy for Pulmonary Vein Occlusion Secondary to Radiofrequency Ablation

Steliga

Ghouri

Massumi

et al. 2010

Cardiovasc electrophysiol

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Pulmonary vein stenosis, a recognized complication of transcatheter radiofrequency ablation in the left atrium, is often asymptomatic. Significant stenosis is commonly treated with percutaneous balloon dilation with or without stenting. We encountered a case of complete pulmonary vein occlusion that caused lobar thrombosis, pleuritic pain, and persistent cough. Imaging studies revealed virtually no perfusion to the affected lobe. A lobectomy was performed, resolving the persistent cough and pain. Pulmonary vein occlusion should be suspected in patients who present with pulmonary symptoms after having undergone ablative procedures for atrial fibrillation. This condition may necessitate surgical intervention if interventions such as balloon dilation or stenting are not possible or are ineffective.

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Section: Discussionmentioning

confidence: 99%

Lobectomy for Pulmonary Vein Occlusion Secondary to Radiofrequency Ablation

Steliga

Ghouri

Massumi

et al. 2010

Cardiovasc electrophysiol

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“…Magnetic resonance imaging (MRI) has also been used to accurately evaluate for PV stenosis [65]. Despite the benefits of no radiation exposure to the patient and no nephrotoxic contrast, MDCT is the preferred imaging modality due to a better special resolution and a very short acquisition time [66]. MRI is an alternative modality that can be used if a patient has a contraindication to contrast dye used in MDCT.…”

Section: Computed Tomographymentioning

confidence: 99%

Imaging techniques in cardiac electrophysiology

Panutich

Knight

2006

Expert Review of Cardiovascular Therapy

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Modern cardiac electrophysiology procedures include catheter-based arrhythmia ablation and transvenous device implantation, which are highly dependent on accurate, real-time cardiac imaging. With the realization that anatomic structures are critical to successful electrophysiologic procedures, accurately defining a patient's cardiac anatomy has become more important. Fluoroscopy allows for 2D imaging of cardiac structures in real-time, and is used to guide catheter and lead placement, but does not allow for visualization of soft tissues. Intracardiac echocardiography allows for both direct visualization of anatomic structures within the heart and real-time imaging during catheter placement. Despite advances in intracardiac echocardiography catheters that allow for larger windows, the ability to accurately delineate anatomic structures depends on the patient's anatomy and operator experience. Neither of these techniques allows for electrical mapping of the heart; however, both anatomic and electrical intracardiac mapping can be achieved with advanced mapping systems. These systems allow for real-time catheter localization, help elucidate cardiac anatomy, evaluate electrical activation during arrhythmias and guide catheter placement for deliverance of radiofrequency current. More recently, 3D cardiac computed tomography has been used to accurately define intracardiac anatomy; however, catheter tracking and electrical mapping cannot be performed by computed tomography. Mapping systems are now being merged with computed tomography images to produce an accurate anatomic and electrical map of the heart to guide catheter ablations. The objective of this paper is to describe the current imaging and mapping techniques used in electrophysiologic procedures.

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Evaluation of the cavotricuspid isthmus and right atrium by multidetector-row computed tomography in patients with common atrial flutter

et al. 2005

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The sizes of the right atrium (RA), cavotricuspid isthmus, and Eustachian valve are predictors of success of radiofrequency catheter ablation for atrial flutter (AFL). We examined the relationship between the sizes of cavotricuspid isthmus as measured by multidetector-row computed tomography (MDCT) and fluoroscopy. We used eight-detector MDCT to measure the tricuspid isthmus of 23 patients prior to linear ablation for common AFL. One patient with a deep pouch in the RA was excluded. Parameters measured were (1) the length of the trace of isthmus (Ti), which was equivalent to the blocking line; (2) the size of the tricuspid isthmus (DTi); and (3) the distance from the tricuspid valve and inferior vena cava (IVC) (LDTi). DTi and LDTi indicate the size of the RA, reflecting the appropriately sized steerable ablation catheter, respectively. Of the 22 patients, 21 were ablated successfully without recurrence of AFL, and clinical success was achieved in one additional patient despite failure to obtain a bidirectional block. Ti, DTi, and LDTi were correlated with fluoroscopy time (r = 0.84, r = 0.88, and r = 0.88, respectively; P < 0.0001), total delivered energy (r = 0.81, r = 0.80, and r = 0.83, respectively; P < 0.0001), and application time (r = 0.84, r = 0.80, and r = 0.87, respectively; P < 0.0001). Measurement of the tricuspid isthmus by MDCT may noninvasively provide important information for successful linear ablation.

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Complications of pulmonary vein isolation by catheter ablation evaluated by ECG-gated multislice computed tomography

Cited by 6 publications

References 10 publications

Lobectomy for Pulmonary Vein Occlusion Secondary to Radiofrequency Ablation

Lobectomy for Pulmonary Vein Occlusion Secondary to Radiofrequency Ablation

Imaging techniques in cardiac electrophysiology

Evaluation of the cavotricuspid isthmus and right atrium by multidetector-row computed tomography in patients with common atrial flutter

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