Pre-ablative high-resolution MRA facilitates electrophysiologic pulmonary vein ablation and reduces fluoroscopy time in patients with paroxysmal atrial fibrillation

J. D. Collins; F. S. Pereies; D. Bello; T. Betts; A. Zachariah; R. Kaliney; G. K. Song; S. M. Shors; J. C. Carr; J. P. Finn

doi:10.1117/12.480098

Pre-ablative high-resolution MRA facilitates electrophysiologic pulmonary vein ablation and reduces fluoroscopy time in patients with paroxysmal atrial fibrillation

J. D. Collins^*, F. S. Pereies, D. Bello, T. Betts, A. Zachariah, R. Kaliney, G. K. Song, S. M. Shors, J. C. Carr, J. P. Finn

^*Corresponding author for this work

Radiology

Research output: Contribution to journal › Conference article › peer-review

Abstract

Purpose Pulmonary MRA generates high-resolution images of the pulmonary veins (PV) and left atrium (LA), permitting characterization of complex PV anatomy, which is useful in electrophysiologic PV catheter ablation, a proven technique for the treatment of paroxysmal atrial fibrillation (PAF). The purpose of this study was to determine if pre-ablative pulmonary MRA with infra-ablative viewing facilitates ablation by reducing fluoroscopy time. Materials/Methods We studied the morphology of the LA and PV at 1.5 T (Magnetom Sonata, Siemens Medical Solutions, Erlangen, Germany) with breath-held gadolinium-enhanced 3D MRA in 7 patients with PAF undergoing PV ablation. Data was volume rendered (VR) on a stereoscopic workstation. PV ostial diameter and cross-sectional area measurements were obtained on multi-planar reformatted (MPR) images. VR datasets were converted into digital movies and were viewed on a laptop computer adjacent to real-time fluoroscopic images. Fluoroscopy times for patients undergoing pre-ablative MRA mapping were compared with a cohort of 22 consecutive patients diagnosed with PAF who underwent catheter ablation without pre-ablative MRA planning. Results Mean PV ablation fluoroscopic time with MRA planning versus fluoroscopic imaging alone were 84 ± 20 minutes and 114 ± 20 minutes respectively. Pre-ablative MRA planning resulted in a significant mean fluoroscopy time savings of 26% (p<0.05). Conclusion In patients with PAF undergoing PV ablation, analysis of MRA datasets depicting PV anatomy confirms that there is great variability in anatomy between veins. Pre-ablative 3D PV mapping by MRA greatly facilitates fluoroscopic identification of individual veins and significantly reduces fluoroscopic radiation time.

Original language	English (US)
Pages (from-to)	267-269
Number of pages	3
Journal	Proceedings of SPIE - The International Society for Optical Engineering
Volume	5034
DOIs	https://doi.org/10.1117/12.480098
State	Published - Sep 12 2003
Event	Medical Imaging 2003: Image Perception, Observer Performance, and Technology Assessment - San Diego, CA, United States Duration: Feb 18 2003 → Feb 20 2003

Keywords

3D MRA
Paroxysmal Atrial Fibrillation
Pulmonary MRA
RF ablation

ASJC Scopus subject areas

Electronic, Optical and Magnetic Materials
Condensed Matter Physics
Computer Science Applications
Applied Mathematics
Electrical and Electronic Engineering

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10.1117/12.480098

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Collins, J. D., Pereies, F. S., Bello, D., Betts, T., Zachariah, A., Kaliney, R., Song, G. K., Shors, S. M., Carr, J. C., & Finn, J. P. (2003). Pre-ablative high-resolution MRA facilitates electrophysiologic pulmonary vein ablation and reduces fluoroscopy time in patients with paroxysmal atrial fibrillation. Proceedings of SPIE - The International Society for Optical Engineering, 5034, 267-269. https://doi.org/10.1117/12.480098

@article{b90e9ab697644d8d9361b828f041b126,

title = "Pre-ablative high-resolution MRA facilitates electrophysiologic pulmonary vein ablation and reduces fluoroscopy time in patients with paroxysmal atrial fibrillation",

abstract = "Purpose Pulmonary MRA generates high-resolution images of the pulmonary veins (PV) and left atrium (LA), permitting characterization of complex PV anatomy, which is useful in electrophysiologic PV catheter ablation, a proven technique for the treatment of paroxysmal atrial fibrillation (PAF). The purpose of this study was to determine if pre-ablative pulmonary MRA with infra-ablative viewing facilitates ablation by reducing fluoroscopy time. Materials/Methods We studied the morphology of the LA and PV at 1.5 T (Magnetom Sonata, Siemens Medical Solutions, Erlangen, Germany) with breath-held gadolinium-enhanced 3D MRA in 7 patients with PAF undergoing PV ablation. Data was volume rendered (VR) on a stereoscopic workstation. PV ostial diameter and cross-sectional area measurements were obtained on multi-planar reformatted (MPR) images. VR datasets were converted into digital movies and were viewed on a laptop computer adjacent to real-time fluoroscopic images. Fluoroscopy times for patients undergoing pre-ablative MRA mapping were compared with a cohort of 22 consecutive patients diagnosed with PAF who underwent catheter ablation without pre-ablative MRA planning. Results Mean PV ablation fluoroscopic time with MRA planning versus fluoroscopic imaging alone were 84 ± 20 minutes and 114 ± 20 minutes respectively. Pre-ablative MRA planning resulted in a significant mean fluoroscopy time savings of 26% (p<0.05). Conclusion In patients with PAF undergoing PV ablation, analysis of MRA datasets depicting PV anatomy confirms that there is great variability in anatomy between veins. Pre-ablative 3D PV mapping by MRA greatly facilitates fluoroscopic identification of individual veins and significantly reduces fluoroscopic radiation time.",

keywords = "3D MRA, Paroxysmal Atrial Fibrillation, Pulmonary MRA, RF ablation",

author = "Collins, {J. D.} and Pereies, {F. S.} and D. Bello and T. Betts and A. Zachariah and R. Kaliney and Song, {G. K.} and Shors, {S. M.} and Carr, {J. C.} and Finn, {J. P.}",

year = "2003",

month = sep,

day = "12",

doi = "10.1117/12.480098",

language = "English (US)",

volume = "5034",

pages = "267--269",

journal = "Proceedings of SPIE - The International Society for Optical Engineering",

issn = "0277-786X",

publisher = "SPIE",

note = "Medical Imaging 2003: Image Perception, Observer Performance, and Technology Assessment ; Conference date: 18-02-2003 Through 20-02-2003",

}

Collins, JD, Pereies, FS, Bello, D, Betts, T, Zachariah, A, Kaliney, R, Song, GK, Shors, SM, Carr, JC & Finn, JP 2003, 'Pre-ablative high-resolution MRA facilitates electrophysiologic pulmonary vein ablation and reduces fluoroscopy time in patients with paroxysmal atrial fibrillation', Proceedings of SPIE - The International Society for Optical Engineering, vol. 5034, pp. 267-269. https://doi.org/10.1117/12.480098

Pre-ablative high-resolution MRA facilitates electrophysiologic pulmonary vein ablation and reduces fluoroscopy time in patients with paroxysmal atrial fibrillation. / Collins, J. D.; Pereies, F. S.; Bello, D. et al.

In: Proceedings of SPIE - The International Society for Optical Engineering, Vol. 5034, 12.09.2003, p. 267-269.

Research output: Contribution to journal › Conference article › peer-review

TY - JOUR

T1 - Pre-ablative high-resolution MRA facilitates electrophysiologic pulmonary vein ablation and reduces fluoroscopy time in patients with paroxysmal atrial fibrillation

AU - Collins, J. D.

AU - Pereies, F. S.

AU - Bello, D.

AU - Betts, T.

AU - Zachariah, A.

AU - Kaliney, R.

AU - Song, G. K.

AU - Shors, S. M.

AU - Carr, J. C.

AU - Finn, J. P.

PY - 2003/9/12

Y1 - 2003/9/12

N2 - Purpose Pulmonary MRA generates high-resolution images of the pulmonary veins (PV) and left atrium (LA), permitting characterization of complex PV anatomy, which is useful in electrophysiologic PV catheter ablation, a proven technique for the treatment of paroxysmal atrial fibrillation (PAF). The purpose of this study was to determine if pre-ablative pulmonary MRA with infra-ablative viewing facilitates ablation by reducing fluoroscopy time. Materials/Methods We studied the morphology of the LA and PV at 1.5 T (Magnetom Sonata, Siemens Medical Solutions, Erlangen, Germany) with breath-held gadolinium-enhanced 3D MRA in 7 patients with PAF undergoing PV ablation. Data was volume rendered (VR) on a stereoscopic workstation. PV ostial diameter and cross-sectional area measurements were obtained on multi-planar reformatted (MPR) images. VR datasets were converted into digital movies and were viewed on a laptop computer adjacent to real-time fluoroscopic images. Fluoroscopy times for patients undergoing pre-ablative MRA mapping were compared with a cohort of 22 consecutive patients diagnosed with PAF who underwent catheter ablation without pre-ablative MRA planning. Results Mean PV ablation fluoroscopic time with MRA planning versus fluoroscopic imaging alone were 84 ± 20 minutes and 114 ± 20 minutes respectively. Pre-ablative MRA planning resulted in a significant mean fluoroscopy time savings of 26% (p<0.05). Conclusion In patients with PAF undergoing PV ablation, analysis of MRA datasets depicting PV anatomy confirms that there is great variability in anatomy between veins. Pre-ablative 3D PV mapping by MRA greatly facilitates fluoroscopic identification of individual veins and significantly reduces fluoroscopic radiation time.

AB - Purpose Pulmonary MRA generates high-resolution images of the pulmonary veins (PV) and left atrium (LA), permitting characterization of complex PV anatomy, which is useful in electrophysiologic PV catheter ablation, a proven technique for the treatment of paroxysmal atrial fibrillation (PAF). The purpose of this study was to determine if pre-ablative pulmonary MRA with infra-ablative viewing facilitates ablation by reducing fluoroscopy time. Materials/Methods We studied the morphology of the LA and PV at 1.5 T (Magnetom Sonata, Siemens Medical Solutions, Erlangen, Germany) with breath-held gadolinium-enhanced 3D MRA in 7 patients with PAF undergoing PV ablation. Data was volume rendered (VR) on a stereoscopic workstation. PV ostial diameter and cross-sectional area measurements were obtained on multi-planar reformatted (MPR) images. VR datasets were converted into digital movies and were viewed on a laptop computer adjacent to real-time fluoroscopic images. Fluoroscopy times for patients undergoing pre-ablative MRA mapping were compared with a cohort of 22 consecutive patients diagnosed with PAF who underwent catheter ablation without pre-ablative MRA planning. Results Mean PV ablation fluoroscopic time with MRA planning versus fluoroscopic imaging alone were 84 ± 20 minutes and 114 ± 20 minutes respectively. Pre-ablative MRA planning resulted in a significant mean fluoroscopy time savings of 26% (p<0.05). Conclusion In patients with PAF undergoing PV ablation, analysis of MRA datasets depicting PV anatomy confirms that there is great variability in anatomy between veins. Pre-ablative 3D PV mapping by MRA greatly facilitates fluoroscopic identification of individual veins and significantly reduces fluoroscopic radiation time.

KW - 3D MRA

KW - Paroxysmal Atrial Fibrillation

KW - Pulmonary MRA

KW - RF ablation

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UR - http://www.scopus.com/inward/citedby.url?scp=0042358947&partnerID=8YFLogxK

U2 - 10.1117/12.480098

DO - 10.1117/12.480098

M3 - Conference article

AN - SCOPUS:0042358947

SN - 0277-786X

VL - 5034

SP - 267

EP - 269

JO - Proceedings of SPIE - The International Society for Optical Engineering

JF - Proceedings of SPIE - The International Society for Optical Engineering

T2 - Medical Imaging 2003: Image Perception, Observer Performance, and Technology Assessment

Y2 - 18 February 2003 through 20 February 2003

ER -

Pre-ablative high-resolution MRA facilitates electrophysiologic pulmonary vein ablation and reduces fluoroscopy time in patients with paroxysmal atrial fibrillation

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Keywords

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