Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende
Erweiterte Suche
Anmelden
nach oben
Current Cardiovascular Imaging Reports
Erschienen in: Current Cardiovascular Imaging Reports 6/2012

01.12.2012 | Echocardiography (MH Picard, Section Editor)

Role of Echocardiography in Pulmonary Vein Ablation for Atrial Fibrillation

verfasst von: Andrew C. Y. To, Allan L. Klein

Erschienen in: Current Cardiovascular Imaging Reports | Ausgabe 6/2012

Einloggen, um Zugang zu erhalten

Abstract

Pulmonary vein ablation is increasingly used for patients with difficult to manage atrial fibrillation. Echocardiography plays a central role in the assessment of patients undergoing ablation therapy, not only in the pre-ablation patient selection and post-ablation assessment, but also in the peri-procedural guidance. Newer echocardiographic techniques including atrial mechanics measurements are also reviewed.
Literatur
1.
Calkins H, Kuck KH, Cappato R, et al. HRS/EHRA/ECAS expert consensus statement on catheter and surgical ablation of atrial fibrillation: recommendations for patient selection, procedural techniques, patient management, and follow-up, definitions, endpoints, and research trial design: a report of the Heart Rhythm Society (HRS) Task Force on Catheter and Surgical Ablation of Atrial Fibrillation. Developed in partnership with the European Heart Rhythm Association (EHRA), a registered branch of the European Society of Cardiology (ESC), and the European Cardiac Arrhythmia Society (ECAS); and in collaboration with the American College of Cardiology (ACC), American Heart Association (AHA), the Asia Pacific Heart Rhythm Society (APHRS), and the Society of Thoracic Surgeons (STS). Endorsed by the governing bodies of the American College of Cardiology Foundation, the American Heart Association, the European Cardiac Arrhythmia Society, the European Heart Rhythm Association, the Society of Thoracic Surgeons, the Asia Pacific Heart Rhythm Society, and the Heart Rhythm Society. Hear Rhythm. 2012;9:632–6 e21.CrossRef
2.
Hsu LF, Jais P, Sanders P, et al. Catheter ablation for atrial fibrillation in congestive heart failure. N Engl J Med. 2004;351:2373–83.PubMedCrossRef
3.
Wann LS, Curtis AB, January CT, et al. ACCF/AHA/HRS focused update on the management of patients with atrial fibrillation (Updating the 2006 Guideline): a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2011;57:223–42.PubMedCrossRef
4.
Echocardiographic predictors of stroke in patients with atrial fibrillation: a prospective study of 1066 patients from 3 clinical trials. Arch Intern Med. 1998;158:1316–20.
5.
Themistoclakis S, Schweikert RA, Saliba WI, et al. Clinical predictors and relationship between early and late atrial tachyarrhythmias after pulmonary vein antrum isolation. Hear Rhythm. 2008;5:679–85.CrossRef
6.
Fuster V, Ryden LE, Cannom DS, et al. ACC/AHA/ESC 2006 guidelines for the management of patients with atrial fibrillation–executive summary; a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation). J Am Coll Cardiol. 2006;48:854–906.PubMedCrossRef
7.
Abhayaratna WP, Seward JB, Appleton CP, et al. Left atrial size: physiologic determinants and clinical applications. J Am Coll Cardiol. 2006;47:2357–63.PubMedCrossRef
8.
Lang RM, Bierig M, Devereux RB, et al. Recommendations for chamber quantification: a report from the American Society of Echocardiography’s Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology. J Am Soc Echocardiogr. 2005;18:1440–63.PubMedCrossRef
9.
Keller AM, Gopal AS, King DL. Left and right atrial volume by freehand three-dimensional echocardiography: in vivo validation using magnetic resonance imaging. Eur J Echocardiogr. 2000;1:55–65.PubMedCrossRef
10.
Artang R, Migrino RQ, Harmann L, Bowers M, Woods TD. Left atrial volume measurement with automated border detection by 3-dimensional echocardiography: comparison with magnetic resonance imaging. Cardiovasc Ultrasound. 2009;7:16.PubMedCrossRef
11.
Jenkins C, Bricknell K, Marwick TH. Use of real-time three-dimensional echocardiography to measure left atrial volume: comparison with other echocardiographic techniques. J Am Soc Echocardiogr. 2005;18:991–7.PubMedCrossRef
12.
Marsan NA, Tops LF, Holman ER, et al. Comparison of left atrial volumes and function by real-time three-dimensional echocardiography in patients having catheter ablation for atrial fibrillation with persistence of sinus rhythm vs recurrent atrial fibrillation three months later. Am J Cardiol. 2008;102:847–53.PubMedCrossRef
13.
Delgado V, Vidal B, Sitges M, et al. Fate of left atrial function as determined by real-time three-dimensional echocardiography study after radiofrequency catheter ablation for the treatment of atrial fibrillation. Am J Cardiol. 2008;101:1285–90.PubMedCrossRef
14.
• Parikh SS, Jons C, McNitt S, Daubert JP, Schwarz KQ, Hall B. Predictive capability of left atrial size measured by CT, TEE, and TTE for recurrence of atrial fibrillation following radiofrequency catheter ablation. Pacing Clin Electrophysiol. 2010;33:532–40. This paper is one of the papers that demonstrates the relationship between left atrial volume and post-ablation recurrence and establishes the role of assessing left atrial size by echocardiography in pulmonary vein isolation. PubMedCrossRef
15.
Perea RJ, Tamborero D, Mont L, et al. Left atrial contractility is preserved after successful circumferential pulmonary vein ablation in patients with atrial fibrillation. J Cardiovasc Electrophysiol. 2008;19:374–9.PubMedCrossRef
16.
Montefusco A, Biasco L, Blandino A, et al. Left atrial volume at MRI is the main determinant of outcome after pulmonary vein isolation plus linear lesion ablation for paroxysmal-persistent atrial fibrillation. J Cardiovasc Med. 2010;11:593–8.CrossRef
17.
Maddukuri PV, Vieira ML, DeCastro S, et al. What is the best approach for the assessment of left atrial size? Comparison of various unidimensional and two-dimensional parameters with three-dimensional echocardiographically determined left atrial volume. J Am Soc Echocardiogr. 2006;19:1026–32.PubMedCrossRef
18.
Vandenberg BF, Weiss RM, Kinzey J, et al. Comparison of left atrial volume by two-dimensional echocardiography and cine-computed tomography. Am J Cardiol. 1995;75:754–7.PubMedCrossRef
19.
Rodevan O, Bjornerheim R, Ljosland M, Maehle J, Smith HJ, Ihlen H. Left atrial volumes assessed by three- and two-dimensional echocardiography compared to MRI estimates. Int J Card Imaging. 1999;15:397–410.PubMedCrossRef
20.
Chen MS, Marrouche NF, Khaykin Y, et al. Pulmonary vein isolation for the treatment of atrial fibrillation in patients with impaired systolic function. J Am Coll Cardiol. 2004;43:1004–9.PubMedCrossRef
21.
Tondo C, Mantica M, Russo G, et al. Pulmonary vein vestibule ablation for the control of atrial fibrillation in patients with impaired left ventricular function. Pacing Clin Electrophysiol. 2006;29:962–70.PubMedCrossRef
22.
Lutomsky BA, Rostock T, Koops A, et al. Catheter ablation of paroxysmal atrial fibrillation improves cardiac function: a prospective study on the impact of atrial fibrillation ablation on left ventricular function assessed by magnetic resonance imaging. Europace. 2008;10:593–9.PubMedCrossRef
23.
Pearson AC, Labovitz AJ, Tatineni S, Gomez CR. Superiority of transesophageal echocardiography in detecting cardiac source of embolism in patients with cerebral ischemia of uncertain etiology. J Am Coll Cardiol. 1991;17:66–72.PubMedCrossRef
24.
Manning WJ, Silverman DI, Keighley CS, Oettgen P, Douglas PS. Transesophageal echocardiographically facilitated early cardioversion from atrial fibrillation using short-term anticoagulation: final results of a prospective 4.5-year study. J Am Coll Cardiol. 1995;25:1354–61.PubMedCrossRef
25.
Manning WJ, Weintraub RM, Waksmonski CA, et al. Accuracy of transesophageal echocardiography for identifying left atrial thrombi. A prospective, intraoperative study. Ann Intern Med. 1995;123:817–22.PubMed
26.
Puwanant S, Varr BC, Shrestha K, et al. Role of the CHADS2 score in the evaluation of thromboembolic risk in patients with atrial fibrillation undergoing transesophageal echocardiography before pulmonary vein isolation. J Am Coll Cardiol. 2009;54:2032–9.PubMedCrossRef
27.
McCready JW, Nunn L, Lambiase PD, et al. Incidence of left atrial thrombus prior to atrial fibrillation ablation: is pre-procedural transoesophageal echocardiography mandatory? Europace. 2010;12:927–32.PubMedCrossRef
28.
Scherr D, Dalal D, Chilukuri K, et al. Incidence and predictors of left atrial thrombus prior to catheter ablation of atrial fibrillation. J Cardiovasc Electrophysiol. 2009;20:379–84.PubMedCrossRef
29.
Zabalgoitia M, Halperin JL, Pearce LA, Blackshear JL, Asinger RW, Hart RG. Transesophageal echocardiographic correlates of clinical risk of thromboembolism in nonvalvular atrial fibrillation. Stroke Prevention in Atrial Fibrillation III Investigators. J Am Coll Cardiol. 1998;31:1622–6.PubMedCrossRef
30.
Fatkin D, Kuchar DL, Thorburn CW, Feneley MP. Transesophageal echocardiography before and during direct current cardioversion of atrial fibrillation: evidence for “atrial stunning” as a mechanism of thromboembolic complications. J Am Coll Cardiol. 1994;23:307–16.PubMedCrossRef
31.
Bernhardt P, Schmidt H, Hammerstingl C, Luderitz B, Omran H. Patients with atrial fibrillation and dense spontaneous echo contrast at high risk a prospective and serial follow-up over 12 months with transesophageal echocardiography and cerebral magnetic resonance imaging. J Am Coll Cardiol. 2005;45:1807–12.PubMedCrossRef
32.
Black IW, Hopkins AP, Lee LC, Walsh WF. Left atrial spontaneous echo contrast: a clinical and echocardiographic analysis. J Am Coll Cardiol. 1991;18:398–404.PubMedCrossRef
33.
To AC, Gabriel RS, Park M, et al. Role of Transesophageal echocardiography compared to computed tomography in evaluation of pulmonary vein ablation for atrial fibrillation (ROTEA study). J Am Soc Echocardiogr. 2011;24:1046–55.PubMedCrossRef
34.
Toffanin G, Scarabeo V, Verlato R, De Conti F, Zampiero AA, Piovesana P. Transoesophageal echocardiographic evaluation of pulmonary vein anatomy in patients undergoing ostial radiofrequency catheter ablation for atrial fibrillation: a comparison with magnetic resonance angiography. J Cardiovasc Med. 2006;7:748–52.CrossRef
35.
Jander N, Minners J, Arentz T, et al. Transesophageal echocardiography in comparison with magnetic resonance imaging in the diagnosis of pulmonary vein stenosis after radiofrequency ablation therapy. J Am Soc Echocardiogr. 2005;18:654–9.PubMedCrossRef
36.
Tabata T, Thomas JD, Klein AL. Pulmonary venous flow by doppler echocardiography: revisited 12 years later. J Am Coll Cardiol. 2003;41:1243–50.PubMedCrossRef
37.
Hof I, Chilukuri K, Arbab-Zadeh A, et al. Does left atrial volume and pulmonary venous anatomy predict the outcome of catheter ablation of atrial fibrillation? J Cardiovasc Electrophysiol. 2009;20:1005–10.PubMedCrossRef
38.
Kato R, Lickfett L, Meininger G, et al. Pulmonary vein anatomy in patients undergoing catheter ablation of atrial fibrillation: lessons learned by use of magnetic resonance imaging. Circulation. 2003;107:2004–10.PubMedCrossRef
39.
Lickfett L, Kato R, Tandri H, et al. Characterization of a new pulmonary vein variant using magnetic resonance angiography: incidence, imaging, and interventional implications of the “right top pulmonary vein”. J Cardiovasc Electrophysiol. 2004;15:538–43.PubMedCrossRef
40.
Lin WS, Prakash VS, Tai CT, et al. Pulmonary vein morphology in patients with paroxysmal atrial fibrillation initiated by ectopic beats originating from the pulmonary veins: implications for catheter ablation. Circulation. 2000;101:1274–81.PubMedCrossRef
41.
Mansour M, Holmvang G, Sosnovik D, et al. Assessment of pulmonary vein anatomic variability by magnetic resonance imaging: implications for catheter ablation techniques for atrial fibrillation. J Cardiovasc Electrophysiol. 2004;15:387–93.PubMedCrossRef
42.
Schwartzman D, Lacomis J, Wigginton WG. Characterization of left atrium and distal pulmonary vein morphology using multidimensional computed tomography. J Am Coll Cardiol. 2003;41:1349–57.PubMedCrossRef
43.
Tsao HM, Wu MH, Yu WC, et al. Role of right middle pulmonary vein in patients with paroxysmal atrial fibrillation. J Cardiovasc Electrophysiol. 2001;12:1353–7.PubMedCrossRef
44.
Mlcochova H, Tintera J, Porod V, Peichl P, Cihak R, Kautzner J. Magnetic resonance angiography of pulmonary veins: implications for catheter ablation of atrial fibrillation. Pacing Clin Electrophysiol. 2005;28:1073–80.PubMedCrossRef
45.
Jongbloed MR, Bax JJ, Lamb HJ, et al. Multislice computed tomography vs intracardiac echocardiography to evaluate the pulmonary veins before radiofrequency catheter ablation of atrial fibrillation: a head-to-head comparison. J Am Coll Cardiol. 2005;45:343–50.PubMedCrossRef
46.
Knackstedt C, Visser L, Plisiene J, et al. Dilatation of the pulmonary veins in atrial fibrillation: a transesophageal echocardiographic evaluation. Pacing Clin Electrophysiol. 2003;26:1371–8.PubMedCrossRef
47.
Saliba W, Thomas J. Intracardiac echocardiography during catheter ablation of atrial fibrillation. Europace. 2008;10 Suppl 3:iii42–7.PubMedCrossRef
48.
Kalman JM, Fitzpatrick AP, Olgin JE, et al. Biophysical characteristics of radiofrequency lesion formation in vivo: dynamics of catheter tip-tissue contact evaluated by intracardiac echocardiography. Am Heart J. 1997;133:8–18.PubMedCrossRef
49.
Marrouche NF, Guenther J, Segerson NM, et al. Randomized comparison between open irrigation technology and intracardiac-echo-guided energy delivery for pulmonary vein antrum isolation: procedural parameters, outcomes, and the effect on esophageal injury. J Cardiovasc Electrophysiol. 2007;18:583–8.PubMedCrossRef
50.
Kanj MH, Wazni O, Fahmy T, et al. Pulmonary vein antral isolation using an open irrigation ablation catheter for the treatment of atrial fibrillation: a randomized pilot study. J Am Coll Cardiol. 2007;49:1634–41.PubMedCrossRef
51.
Holmes D, Fish JM, Byrd IA, et al. Contact sensing provides a highly accurate means to titrate radiofrequency ablation lesion depth. J Cardiovasc Electrophysiol. 2011;22:684–90.PubMedCrossRef
52.
Helms A, West JJ, Patel A, et al. Real-time rotational ICE imaging of the relationship of the ablation catheter tip and the esophagus during atrial fibrillation ablation. J Cardiovasc Electrophysiol. 2009;20:130–7.PubMedCrossRef
53.
Kenigsberg DN, Lee BP, Grizzard JD, Ellenbogen KA, Wood MA. Accuracy of intracardiac echocardiography for assessing the esophageal course along the posterior left atrium: a comparison to magnetic resonance imaging. J Cardiovasc Electrophysiol. 2007;18:169–73.PubMedCrossRef
54.
Saad EB, Rossillo A, Saad CP, et al. Pulmonary vein stenosis after radiofrequency ablation of atrial fibrillation: functional characterization, evolution, and influence of the ablation strategy. Circulation. 2003;108:3102–7.PubMedCrossRef
55.
Dong J, Vasamreddy CR, Jayam V, et al. Incidence and predictors of pulmonary vein stenosis following catheter ablation of atrial fibrillation using the anatomic pulmonary vein ablation approach: results from paired magnetic resonance imaging. J Cardiovasc Electrophysiol. 2005;16:845–52.PubMedCrossRef
56.
Yang HM, Lai CK, Patel J, et al. Irreversible intrapulmonary vascular changes after pulmonary vein stenosis complicating catheter ablation for atrial fibrillation. Cardiovasc Pathol. 2007;16:51–5.PubMedCrossRef
57.
Sigurdsson G, Troughton RW, Xu XF, et al. Detection of pulmonary vein stenosis by transesophageal echocardiography: comparison with multidetector computed tomography. Am Heart J. 2007;153:800–6.PubMedCrossRef
58.
Morillo CA, Klein GJ, Jones DL, Guiraudon CM. Chronic rapid atrial pacing. Structural, functional, and electrophysiological characteristics of a new model of sustained atrial fibrillation. Circulation. 1995;91:1588–95.PubMedCrossRef
59.
Wijffels MC, Kirchhof CJ, Dorland R, Power J, Allessie MA. Electrical remodeling due to atrial fibrillation in chronically instrumented conscious goats: roles of neurohumoral changes, ischemia, atrial stretch, and high rate of electrical activation. Circulation. 1997;96:3710–20.PubMedCrossRef
60.
Wijffels MC, Kirchhof CJ, Dorland R, Allessie MA. Atrial fibrillation begets atrial fibrillation. A study in awake chronically instrumented goats. Circulation. 1995;92:1954–68.PubMedCrossRef
61.
To AC, Flamm SD, Marwick TH, Klein AL. Clinical utility of multimodality LA imaging: assessment of size, function, and structure. JACC Cardiovascular Imaging. 2011;4:788–98.PubMedCrossRef
62.
•• Saraiva RM, Dem Irkol S, Buakhamsri A, et al. Left atrial strain measured by two-dimensional speckle tracking represents a new tool to evaluate left atrial function. J Am Soc Echocardiogr. 2010;23:172–80. This paper outlines the use of speckle tracking techniques in measuring left atrial mechanics. PubMedCrossRef
63.
Vianna-Pinton R, Moreno CA, Baxter CM, Lee KS, Tsang TS, Appleton CP. Two-dimensional speckle-tracking echocardiography of the left atrium: feasibility and regional contraction and relaxation differences in normal subjects. J Am Soc Echocardiogr. 2009;22:299–305.PubMedCrossRef
64.
Schneider C, Malisius R, Krause K, et al. Strain rate imaging for functional quantification of the left atrium: atrial deformation predicts the maintenance of sinus rhythm after catheter ablation of atrial fibrillation. Eur Heart J. 2008;29:1397–409.PubMedCrossRef
65.
Motoki H, Dahiya A, Bhargava M, et al. Assessment of left atrial mechanics in patients with atrial fibrillation: comparison between two-dimensional speckle-based strain and velocity vector imaging. J Am Soc Echocardiogr. 2012;25:428–35.PubMedCrossRef
66.
Jayam VK, Dong J, Vasamreddy CR, et al. Atrial volume reduction following catheter ablation of atrial fibrillation and relation to reduction in pulmonary vein size: an evaluation using magnetic resonance angiography. J Interv Card Electrophysiol. 2005;13:107–14.PubMedCrossRef
67.
Tsao HM, Wu MH, Huang BH, et al. Morphologic remodeling of pulmonary veins and left atrium after catheter ablation of atrial fibrillation: insight from long-term follow-up of three-dimensional magnetic resonance imaging. J Cardiovasc Electrophysiol. 2005;16:7–12.PubMedCrossRef
68.
Hammerstingl C, Schwekendiek M, Momcilovic D, et al. Left atrial deformation imaging with ultrasound based two-dimensional speckle-tracking predicts the rate of recurrence of paroxysmal and persistent atrial fibrillation after successful ablation procedures. J Cardiovasc Electrophysiol. 2012;23:247–55.PubMedCrossRef
69.
Mirza M, Caracciolo G, Khan U, et al. Left atrial reservoir function predicts atrial fibrillation recurrence after catheter ablation: a two-dimensional speckle strain study. J Intervent Cardiac Electrophysiol. 2011;31:197–206.CrossRef
70.
To AC, Klein AL. Role of echocardiography in atrial fibrillation ablation. JAFIB J Atrial Fibrillation. 2011;2:1–12.
Metadaten
Titel
Role of Echocardiography in Pulmonary Vein Ablation for Atrial Fibrillation
verfasst von
Andrew C. Y. To
Allan L. Klein
Publikationsdatum
01.12.2012
Verlag
Current Science Inc.
Erschienen in
Current Cardiovascular Imaging Reports / Ausgabe 6/2012
Print ISSN: 1941-9066
Elektronische ISSN: 1941-9074
DOI
https://doi.org/10.1007/s12410-012-9170-4

Weitere Artikel der Ausgabe 6/2012

Current Cardiovascular Imaging Reports 6/2012 Zur Ausgabe

Echocardiography (MH Picard, Section Editor)

Multimodality Imaging in Congenital Heart Disease: an Update

Echocardiography (MH Picard, Section Editor)

Role of Echocardiography to Guide New Transcatheter Interventions for Valvular Heart Disease

Echocardiography (MH Picard, Section Editor)

Diagnosis in a Heart Beat, or Focused Echocardiography: How Should it be Used in the Emergency Room?

Echocardiography (MH Picard, Section Editor)

Assessing the Athlete’s Heart

Echocardiography (MH Picard, Section Editor)

Assessing the Cardiac Toxicity of Chemotherapeutic Agents: Role of Echocardiography

Hot Topic

18F-FDG Cardiac Studies for Identifying Ischemic Memory

Neu im Fachgebiet Kardiologie

24.04.2024 | DGIM 2024 | Kongressbericht | Nachrichten

Myokarditis nach Infekt – richtig schwierig wird es bei Profisportlern

23.04.2024 | Ablationstherapie | Nachrichten

Wie erfolgreich ist eine Re-Ablation nach Rezidiv?

23.04.2024 | Prävention und Rehabilitation in der Kardiologie | Nachrichten

Europäische Ernährungsgewohnheiten: Das sind die häufigsten Fehler

19.04.2024 | Vorhofflimmern | Nachrichten

Parodontalbehandlung verbessert Prognose bei Katheterablation
weitere anzeigen

Update Kardiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen