BACKGROUND: Left atrial (LA) volume determines prognosis and response to therapy for atrial fibrillation. Integration of electroanatomic maps with three-dimensional images rendered from computed tomography and magnetic resonance imaging (MRI) is used to facilitate atrial fibrillation ablation. OBJECTIVE: The purpose of this study was to measure LA volume changes and regional motion during the cardiac cycle that might affect the accuracy of image integration and to determine their relationship to standard LA volume measurements. METHODS: MRI was performed in 30 patients with paroxysmal atrial fibrillation. LA time-volume curves were generated and used to divide LA ejection fraction into pumping ejection fraction and conduit ejection fraction and to determine maximum LA volume (LA(max)) and preatrial contraction volume. LA volume was measured using an MRI angiogram and traditional geometric models from echocardiography (area-length model and ellipsoid model). In-plane displacement of the pulmonary veins, anterior left atrium, mitral annulus, and LA appendage was measured. RESULTS: LA(max) was 107 +/- 36 mL and occurred at 42% +/- 5% of the R-R interval. Preatrial contraction volume was 86 +/- 34 mL and occurred at 81% +/- 4% of the R-R interval. LA ejection fraction was 45% +/- 10%, and pumping ejection fraction was 31% +/- 10%. LA volume measurements made from MRI angiogram, area-length model, and ellipsoid model underestimated LA(max) by 21 +/- 25 mL, 16 +/- 26 mL, and 35 +/- 22 mL, respectively. Anterior LA, mitral annulus, and LA appendage were significantly displaced during the cardiac cycle (8.8 +/- 2.0 mm, 13.2 +/- 3.8 mm, and 10.2 +/- 3.4 mm, respectively); the pulmonary veins were not displaced. CONCLUSION: LA volume changes significantly during the cardiac cycle, and substantial regional variation in LA motion exists. Standard measurements of LA volume significantly underestimate LA(max) compared to the gold standard measure of three-dimensional volumetrics.
BACKGROUND: Left atrial (LA) volume determines prognosis and response to therapy for atrial fibrillation. Integration of electroanatomic maps with three-dimensional images rendered from computed tomography and magnetic resonance imaging (MRI) is used to facilitate atrial fibrillation ablation. OBJECTIVE: The purpose of this study was to measure LA volume changes and regional motion during the cardiac cycle that might affect the accuracy of image integration and to determine their relationship to standard LA volume measurements. METHODS: MRI was performed in 30 patients with paroxysmal atrial fibrillation. LA time-volume curves were generated and used to divide LA ejection fraction into pumping ejection fraction and conduit ejection fraction and to determine maximum LA volume (LA(max)) and preatrial contraction volume. LA volume was measured using an MRI angiogram and traditional geometric models from echocardiography (area-length model and ellipsoid model). In-plane displacement of the pulmonary veins, anterior left atrium, mitral annulus, and LA appendage was measured. RESULTS: LA(max) was 107 +/- 36 mL and occurred at 42% +/- 5% of the R-R interval. Preatrial contraction volume was 86 +/- 34 mL and occurred at 81% +/- 4% of the R-R interval. LA ejection fraction was 45% +/- 10%, and pumping ejection fraction was 31% +/- 10%. LA volume measurements made from MRI angiogram, area-length model, and ellipsoid model underestimated LA(max) by 21 +/- 25 mL, 16 +/- 26 mL, and 35 +/- 22 mL, respectively. Anterior LA, mitral annulus, and LA appendage were significantly displaced during the cardiac cycle (8.8 +/- 2.0 mm, 13.2 +/- 3.8 mm, and 10.2 +/- 3.4 mm, respectively); the pulmonary veins were not displaced. CONCLUSION: LA volume changes significantly during the cardiac cycle, and substantial regional variation in LA motion exists. Standard measurements of LA volume significantly underestimate LA(max) compared to the gold standard measure of three-dimensional volumetrics.
Authors: Jun Dong; Hugh Calkins; Stephen B Solomon; Shenghan Lai; Darshan Dalal; Albert C Lardo; Al Lardo; Erez Brem; Assaf Preiss; Ronald D Berger; Henry Halperin; Timm Dickfeld Journal: Circulation Date: 2006-01-09 Impact factor: 29.690
Authors: Cheuk-Man Yu; Fang Fang; Qing Zhang; Gabriel W K Yip; Chun Mei Li; Joseph Yat-Sun Chan; LiWen Wu; Jeffrey Wing-Hong Fung Journal: J Am Coll Cardiol Date: 2007-08-06 Impact factor: 24.094
Authors: Peter M Kistler; Mark J Earley; Stuart Harris; Dominic Abrams; Stephen Ellis; Simon C Sporton; Richard J Schilling Journal: J Cardiovasc Electrophysiol Date: 2006-04
Authors: M Haïssaguerre; P Jaïs; D C Shah; S Garrigue; A Takahashi; T Lavergne; M Hocini; J T Peng; R Roudaut; J Clémenty Journal: Circulation Date: 2000-03-28 Impact factor: 29.690
Authors: Antonio Berruezo; David Tamborero; Lluis Mont; Begoña Benito; Jose María Tolosana; Marta Sitges; Bárbara Vidal; Germán Arriagada; Francisco Méndez; Maria Matiello; Irma Molina; Josep Brugada Journal: Eur Heart J Date: 2007-03-29 Impact factor: 29.983
Authors: Yoshihide Takahashi; Mark D O'Neill; Méléze Hocini; Patricia Reant; Anders Jonsson; Pierre Jaïs; Prashanthan Sanders; Thomas Rostock; Martin Rotter; Frédéric Sacher; Stephane Laffite; Raymond Roudaut; Jacques Clémenty; Michel Haïssaguerre Journal: J Am Coll Cardiol Date: 2007-03-09 Impact factor: 24.094
Authors: Dana C Peters; John V Wylie; Thomas H Hauser; Kraig V Kissinger; René M Botnar; Vidal Essebag; Mark E Josephson; Warren J Manning Journal: Radiology Date: 2007-06 Impact factor: 11.105
Authors: Ehud J Schmidt; Maggie M Fung; Pelin Aksit Ciris; Ting Song; Ajit Shankaranarayanan; Godtfred Holmvang; Sandeep N Gupta; Miguel Chaput; Robert A Levine; Jeremy Ruskin; Vivek Y Reddy; Andre D'avila; Anthony H Aletras; Stephan B Danik Journal: Europace Date: 2013-09-06 Impact factor: 5.214
Authors: J Tobias Kühl; Jacob Lønborg; Andreas Fuchs; Mads J Andersen; Niels Vejlstrup; Henning Kelbæk; Thomas Engstrøm; Jacob E Møller; Klaus F Kofoed Journal: Int J Cardiovasc Imaging Date: 2011-08-17 Impact factor: 2.357