Skip to main content
Log in

Direct comparison of computed tomography and magnetic resonance imaging for characterization of posterior left atrial morphology

  • Published:
Journal of Interventional Cardiac Electrophysiology Aims and scope Submit manuscript

Abstract

Objective

Accumulating evidence points to the central importance of the posterior left atrium (PLA) for atrial fibrillation (AF). Catheter ablation intended to cure AF is increasingly practiced; performance and assessment of this procedure is enhanced by accurate imaging of PLA anatomy. Prior reports have suggested that both computed tomographic (CT) and magnetic resonance (MR) imaging techniques provide accurate PLA images. These techniques have never been compared directly.

Materials and methods

Twenty patients referred for catheter ablation underwent preoperative imaging using both CT and MR. Each technique was used to create a multidimensional image of the PLA.

Results

Within patients, morphologic and dimensional PLA indices, including number of individual pulmonary venoatrial junctions, presence of ostial branches, circumference of each venoatrial junction, venoatrial junction “non-circularity”, and distance between ipsilateral superior and inferior venoatrial junctions, were well correlated.

Conclusions

CT and MR-based images of the PLA appear comparable. Technique selection should involve considerations of toxicity, tolerance, and local resources.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Schwartzman, D., Lacomis, J., & Wigginton, W. (2003). Characterization of left atrium and distal pulmonary vein morphology using multidimensional computed tomography. Journal of the American College Cardiology, 41, 1349–1357.

    Article  Google Scholar 

  2. Jongbloed, M., Bax, J., & Lamb, H. (2005). Multislice computed tomography versus intracardiac echocardiography to evaluate pulmonary veins before radiofrequency catheter ablation of atrial fibrillation: A head-to-head comparison. Journal of the American College of Cardiology, 45, 343–350.

    Article  PubMed  Google Scholar 

  3. Cronin, P., Sneider, M., Kazerooni, E., Kelly, A., Scharf, C., Oral, H., et al. (2004). MDCT of the left atrium and pulmonary veins in planning radiofrequency ablation for atrial fibrillation: A how-to guide. American Journal of Radiology, 183, 767–778.

    Google Scholar 

  4. Takase, B., Nagata, M., Matsui, T., Kihara, T., Kameyama, A., Hamabe, A., (2004). Pulmonary vein dimensions and variation of branching pattern in patients with paroxysmal atrial fibrillation using magnetic resonance angiography. Japanese Heart Journal, 45, 81–92.

    Article  PubMed  Google Scholar 

  5. Kato, R., Lickfett, L., Meininger, G., Dickfeld, T., Wu, R., Juang, G., et al. (2003). Pulmonary vein anatomy in patients undergoing catheter ablation of atrial fibrillation. Lessons learned by use of magnetic resonance imaging. Circulation, 107, 2004–2010.

    Article  PubMed  Google Scholar 

  6. Dill, T., Neumann, T., & Ekinci, O. (2003). Pulmonary vein diameter reduction after radiofrequency catheter ablation for paroxysmal atrial fibrillation evaluated by contrast-enhanced three-dimensional magnetic resonance imaging. Circular, 107, 845–850.

    Article  Google Scholar 

  7. Mansour, M., Holmvang, G., & Sosnovik, D. (2004). Assessment of pulmonary vein anatomic variability by magnetic resonance imaging: Implications for catheter ablation techniques for atrial fibrillation. Journal of Cardiovascular Electrophysiology, 15, 387–393.

    Article  PubMed  Google Scholar 

  8. Tops, L., Bax, J., Zeppenfeld, K., Jongbloed, M., Lamb, H., van der Wall, E., et al. (2005). Fusion of multislice computed tomography imaging with three-dimensional electroanatomic mapping to guide radiofrequency catheter ablation procedures. Heart Rhythm, 2, 1076–1081.

    Article  PubMed  Google Scholar 

  9. Schwartzman, D. (2003). Catheter ablation to suppress atrial fibrillation: Evolution of technique at a single center. Journal of Interventional Cardiac Electrophysiology, 9, 295–300.

    Article  PubMed  Google Scholar 

  10. Schwartzman, D. (2004). The common left pulmonary vein: A consistent source of arrhythmogenic atrial ectopy. Journal of Cardiovascular Electrophysiology, 15, 560–566.

    Article  PubMed  Google Scholar 

  11. Juergens, K., Grude, M., Maintz, D., Fallenberg, E., Wichter, T., Heindel, W., et al. (2004). Multi-detector row CT of left ventricular function with dedicated analysis software versus MR imaging: Initial experience. Radiology, 230, 403–410.

    PubMed  Google Scholar 

  12. Mahnken, A., Koos, R., Katoh, M., Spuentrup, E., Busch, P., Wildberger, J., et al. (2005). Sixteen-slice spiral CT versus MR imaging for the assessment of left ventricular function in acute myocardial infarction. European Radiology, 15, 714–720.

    Article  PubMed  Google Scholar 

  13. Hager, A., Kaemmerer, H., Leppert, A., Prokop, M., Blucher, S., Stern, H., et al. (2004). Follow-up of adults with coarctation of the aorta: Comparison of helical CT and MRI, and impact on assessing diameter changes. Chest, 126, 1169–1176.

    Article  PubMed  Google Scholar 

  14. Nonent, M., Serfaty, J., Nighoghossian, N., Rouhart, F., Derex, L., Rotaru, C., et al. (2004). Concordance rate differences of 3 noninvasive imaging techniques to measure carotid stenosis in clinical routine practice: Results of the CARMEDAS multicenter study. Stroke, 35, 682–686.

    Article  PubMed  Google Scholar 

  15. Lacomis, J., Wigginton, W., Fuhrman, C., Schwartzman, D., Armfeld, D., Pealer, K. (2003). Multi-detector row CT of the left atrium and pulmonary veins before radiofrequency catheter ablation for atrial fibrillation. Radiographics, 23, S35–S50.

    PubMed  Google Scholar 

  16. Dickfeld, T., Calkins, H., Bradley, D., & Solomon, S. (2005). Stereotactic catheter navigation using magnetic resonance image integration in the human heart. Heart Rhythm, 2, 413–415.

    Article  PubMed  Google Scholar 

  17. Schwartzman, D., Kanzaki, H., Bazaz, R., & Gorcsan, J. (2004). Impact of catheter ablation on pulmonary vein morphology and mechanical function. Journal of Cardiovascular Electrophysiology, 15, 161–167.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to David Schwartzman.

Additional information

Supported in part by an unrestricted grant from General Electric Healthcare.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lacomis, J.M., Pealer, K., Fuhrman, C.R. et al. Direct comparison of computed tomography and magnetic resonance imaging for characterization of posterior left atrial morphology. J Interv Card Electrophysiol 16, 7–13 (2006). https://doi.org/10.1007/s10840-006-9016-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10840-006-9016-6

Keywords

Navigation