- Oral presentation
- Open Access
Relationship of ostial pulmonary vein scar with reduction in pulmonary vein size after atrial fibrillation ablation
© Hauser et al; licensee BioMed Central Ltd. 2009
- Published: 28 January 2009
- Atrial Fibrillation
- Cross Sectional Area
- Cardiovascular Magnetic Resonance
- Pulmonary Vein
- Left Atrium
Atrial fibrillation (AF) is the most common sustained arrhythmia. Ablation procedures to electrically isolate the pulmonary veins (PV) from the left atrium have become increasingly popular for the prevention of recurrent AF. PV stenosis is a rare but serious complication of the procedure, thought to be due to scarring of the PV. Previous studies have shown that the intensity of ablation is related to the reduction in PV size after the procedure, but direct assessment of scar in patients has not been performed.
We sought to define the relationship of the change PV size after AF ablation with ostial PV scar as determined by late gadolinium enhancement (LGE) cardiovascular magnetic resonance (CMR).
We performed 3D breath-held contrast-enhanced CMR angiography of the PV before and after AF ablation using a 1.5 T MR system. The diameter and cross sectional area (CSA) were determined in the sagittal plane using a previously published method. LGE CMR of the left atrium and PV was obtained after AF ablation using a high-resolution, 3D, navigator gated technique. The scar volume at the ostium of each PV was measured using a threshold technique. The scar volume was normalized to the PV CSA. The change in PV diameter and CSA was expressed as the percentage change compared to the pre-AF ablation PV measurement. The change in PV size before and after evaluation was evaluated using a paired T test. The relationship of the change in PV diameter and CSA to ostial PV scar was evaluated with standard correlation and linear regression.
PV diameter and CSA significantly decrease after AF ablation. There is a linear relationship between these changes and the magnitude of PV scar as measured by LGE MR.
This article is published under license to BioMed Central Ltd.