Pulmonary vein and left atrial changes during the cardiac cycle, pre and post pulmonary vein isolation
© Peters et al; licensee BioMed Central Ltd. 2010
Published: 21 January 2010
High resolution late gadolinium enhancement (LGE) of the left atrium (LA) and pulmonary veins (PV) performed after PV isolation (PVI) demonstrates the ablation pattern, but would benefit from imaging during the period of least motion. LA area changes during the cardiac cycle have been studied in normal subjects . The PV ostial size variations throughout the cardiac cycle have also been measured in pre-PVI patients .
To improve high resolution imaging, by finding the period of minimal motion of the PVs and LA in patients with atrial fibrillation (AF) before and after PVI.
Five patients were studied in sinus rhythm prior to and about 30 days after PVI. A 2-chamber cine scan containing the LA and 8 sagittally-oriented slices were acquired around the left and right PV ostia. Scan parameters were: 2 × 2 × 8 mm, 30 cardiac phases, TR/θ = 4.1 ms/60º retrospective ecg-gating with balanced SSFP. ROIs were traced around the PV ostia of the right inferior, right superior, left inferior and left superior PVs (RIPV, RSPV, LIPV, LSPV), and the LA chamber. The area was measured, and recorded in 15 equally spaced phases throughout the RR.
Conclusion and discussion
A period of minimal motion for the LA and PVs exists from 65 to 85% of the RR interval, as previously reported (1). This study is limited by the challenge of reproducibly choosing the optimal slice at the ostia of the PV.
This article is published under license to BioMed Central Ltd.