Determination of the Spatial Orientation and Shape of Pulmonary Vein Ostia by Contrast-enhanced Magnetic Resonance Angiography

Overview

Journal Europace

Publisher Oxford University Press

Specialties Cardiology & Vascular Diseases
Physiology

Date 2006 Apr 22

PMID 16627401

Citations 7

Authors

Pepijn H van der Voort

Harrie Van Den Bosch

Johannes C Post

Albert Meijer

Affiliations

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Abstract

Aims: For catheter ablation of atrial fibrillation (AF), proper catheter positioning is crucial and depends on knowledge of pulmonary vein (PV) anatomy. The aim of this study was to assess PV spatial orientation and ostial shape by contrast-enhanced magnetic resonance angiography (CE-MRA).

Methods And Results: In 30 consecutive AF patients, CE-MRA was performed prior to ostial ablation. Using a centre-line technique, the PV ostium was defined perpendicular to this centre-line. Minimal and maximal ostial diameters, ostial perimeter, and angles in the anatomical frontal and transverse planes were measured. Twenty-one patients had four separate PVs. In four patients, there was a distinct right-middle PV and in five a common left common PV was found. Left-sided PV ostia were smaller and more elliptical than right-sided PVs. In the transverse plane, the ostia of both superior PVs were directed anteriorly (LS -15 +/- 13 degrees , RS -13 +/- 11 degrees ) and both inferior PV ostia were directed posteriorly (LI 23 +/- 15 degrees , RI 39 +/- 15 degrees ). In the frontal plane, both superior PV ostia pointed upwards (LS -27 +/- 14 degrees , RS -33 +/- 12 degrees ) while the inferior ostia were directed horizontally (LI 2 +/- 11 degrees , RI 3 +/- 13 degrees ).

Conclusion: PV ostial shape and spatial orientation are variable and can be visualized adequately by CE-MRA.

Citing Articles

Radiologic review of acquired pulmonary vein stenosis in adults.

Galizia M, Renapurkar R, Prieto L, Bolen M, Azok J, Lau C Cardiovasc Diagn Ther. 2018; 8(3):387-398.

PMID: 30057885 PMC: 6039802. DOI: 10.21037/cdt.2018.05.05.

Pulmonary vein orientation assessment: Is it necessary in patients undergoing contact force sensing guided radiofrequency catheter ablation of atrial fibrillation.

Gal P, Ooms J, Ottervanger J, Smit J, Adiyaman A, Ramdat Misier A Int J Cardiol Heart Vasc. 2017; 8:1-5.

PMID: 28785670 PMC: 5497231. DOI: 10.1016/j.ijcha.2015.03.009.

Assessments of pulmonary vein and left atrial anatomical variants in atrial fibrillation patients for catheter ablation with cardiac CT.

Chen J, Yang Z, Xu H, Shi K, Long Q, Guo Y Eur Radiol. 2016; 27(2):660-670.

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Pulmonary vein anatomy assessed by cardiac magnetic resonance imaging in patients undergoing initial atrial fibrillation ablation: implications for novel ablation technologies.

Merchant F, Levy M, Iravanian S, Clermont E, Kelli H, Eisner R J Interv Card Electrophysiol. 2016; 46(2):89-96.

PMID: 26810707 DOI: 10.1007/s10840-016-0106-9.

Spatial torsion of the ipsilateral superior and inferior pulmonary veins.

Chen S, Lu X, Zhen Y, Zhuge Y, Zhang F, Chen G J Interv Card Electrophysiol. 2013; 37(1):35-40.

PMID: 23389053 DOI: 10.1007/s10840-012-9771-5.