Sohns C, Vollmann D, Luethje L, Dorenkamp M, Seegers J, Schmitto JD, Zabel M, Obenauer S. MDCT in the diagnostic algorithm in patients with symptomatic atrial fibrillation. World J Radiol 2011; 3(2): 41-46 [PMID: 21390192 DOI: 10.4329/wjr.v3.i2.41]
Corresponding Author of This Article
Silvia Obenauer, MD, Professor, Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, D-40225 Dusseldorf, Germany. obenauerheuser@yahoo.de
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Editorial
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World J Radiol. Feb 28, 2011; 3(2): 41-46 Published online Feb 28, 2011. doi: 10.4329/wjr.v3.i2.41
MDCT in the diagnostic algorithm in patients with symptomatic atrial fibrillation
Christian Sohns, Dirk Vollmann, Lars Luethje, Marc Dorenkamp, Joachim Seegers, Jan D Schmitto, Markus Zabel, Silvia Obenauer
Christian Sohns, Dirk Vollmann, Lars Luethje, Marc Dorenkamp, Joachim Seegers, Markus Zabel, Department of Cardiology and Pneumology, Heart Center, Georg-August-University Goettingen, D-37077 Goettingen, Germany
Jan D Schmitto, Division of Cardiac Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, United States
Silvia Obenauer, Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, D-40225 Dusseldorf, Germany
Author contributions: Sohns C as the primary author conceived the idea and wrote the main part of the manuscript together with Obenauer S and Zabel M; Vollmann D and Seegers J researched literature and designed the electrophysiologic section; Luethje L and Dorenkamp M obtained information regarding the role of three-dimensional imaging techniques prior to pulmonary vein isolation; Schmitto JD contributed to the discussion regarding anatomical considerations; all authors assisted in drafting and critical revision of the manuscript.
Correspondence to: Silvia Obenauer, MD, Professor, Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, D-40225 Dusseldorf, Germany. obenauerheuser@yahoo.de
Telephone: +49-211-8117528 Fax: +49-211-8117522
Received: October 15, 2010 Revised: January 22, 2011 Accepted: January 25, 2011 Published online: February 28, 2011
Abstract
Atrial fibrillation (AF) is the most common supraventricular arrhythmia and a major cause of morbidity. Arrhythmogenic foci originating within the pulmonary veins (PVs) are an important cause of both paroxysmal and persistent AF. A variety of endovascular and surgical techniques have been used to electrically isolate the PV from the left atrium. Pulmonary venography for localization of the PV ostium can be difficult to perform during the ablation procedure. While the anatomy of the PV is patient-specific, non-invasive imaging techniques may provide useful diagnostic information prior to the intended intervention. In this context, multidetector computed tomography (MDCT) visualization of the left atrial and PV anatomy prior to left atrial ablation and PV isolation is becoming increasingly important. MDCT imaging provides pre-procedural information on the left atrial anatomy, including atrial size and venous attachments, and it may identify potential post-procedural complications, such as pulmonary vein stenosis or cardiac perforations. Here, we review the relevant literature and present the current “state-of-the-art” of left atrial anatomy, PV ostia as well as the clinical aspects of refractory AF, MDCT imaging protocols and procedural aspects of PV ablation.
