RATIONALE AND OBJECTIVES: Patients with atrial fibrillation undergo structural remodeling resulting in increased pulmonary vein sizes. Studies have demonstrated that these changes are reversible following successful ablation therapy. To date, analyses of pulmonary vein structure have focused on measurements at the pulmonary vein ostia, and the full extent of reverse remodeling along the length of the pulmonary veins has not yet been fully characterized. MATERIALS AND METHODS: An automated, three-dimensional method is proposed that quantifies pulmonary vein geometry starting at the ostia and extending several centimeters into the veins. A centerline is tracked along the length of the pulmonary vein, and orthogonal planes are computed along the curve. The method was validated against manual measurements on each of the four pulmonary veins for 10 subjects. The proposed methodology was used to analyze the pulmonary veins in 21 patients undergoing cardiac ablation therapy with preoperative and postoperative computed tomographic scans. RESULTS: Validation results demonstrated that the automated measurements closely followed the manual measurements, with an overall mean difference of 11.50 mm(2). Significant differences in cross-sectional area at the two time points were observed at all pulmonary vein ostia and extending for 2.0 cm (excluding the 0.5-cm interval) into the left inferior pulmonary vein, 3.5 cm into the left superior pulmonary vein, and 2.0 cm into the right superior pulmonary vein. CONCLUSIONS: Quantitative analysis along the length of the pulmonary veins can be accomplished using centerline tracking and measurements from orthogonal planes along the curve. The patient study demonstrated that reverse structural remodeling following ablation therapy occurs not only at the ostia but for several centimeters extending into the pulmonary veins.
RATIONALE AND OBJECTIVES:Patients with atrial fibrillation undergo structural remodeling resulting in increased pulmonary vein sizes. Studies have demonstrated that these changes are reversible following successful ablation therapy. To date, analyses of pulmonary vein structure have focused on measurements at the pulmonary vein ostia, and the full extent of reverse remodeling along the length of the pulmonary veins has not yet been fully characterized. MATERIALS AND METHODS: An automated, three-dimensional method is proposed that quantifies pulmonary vein geometry starting at the ostia and extending several centimeters into the veins. A centerline is tracked along the length of the pulmonary vein, and orthogonal planes are computed along the curve. The method was validated against manual measurements on each of the four pulmonary veins for 10 subjects. The proposed methodology was used to analyze the pulmonary veins in 21 patients undergoing cardiac ablation therapy with preoperative and postoperative computed tomographic scans. RESULTS: Validation results demonstrated that the automated measurements closely followed the manual measurements, with an overall mean difference of 11.50 mm(2). Significant differences in cross-sectional area at the two time points were observed at all pulmonary vein ostia and extending for 2.0 cm (excluding the 0.5-cm interval) into the left inferior pulmonary vein, 3.5 cm into the left superior pulmonary vein, and 2.0 cm into the right superior pulmonary vein. CONCLUSIONS: Quantitative analysis along the length of the pulmonary veins can be accomplished using centerline tracking and measurements from orthogonal planes along the curve. The patient study demonstrated that reverse structural remodeling following ablation therapy occurs not only at the ostia but for several centimeters extending into the pulmonary veins.
Authors: Ritsushi Kato; Lars Lickfett; Glenn Meininger; Timm Dickfeld; Richard Wu; George Juang; Piamsook Angkeow; Jennifer LaCorte; David Bluemke; Ronald Berger; Henry R Halperin; Hugh Calkins Journal: Circulation Date: 2003-04-07 Impact factor: 29.690
Authors: Dennis W den Uijl; Laurens F Tops; Victoria Delgado; Joanne D Schuijf; Lucia J M Kroft; Albert de Roos; Eric Boersma; Serge A Trines; Katja Zeppenfeld; Martin J Schalij; Jeroen J Bax Journal: Am J Cardiol Date: 2011-01-15 Impact factor: 2.778
Authors: Maryam E Rettmann; David R Holmes; Jerome F Breen; Xin Ge; Ronald A Karwoski; Kristi H Monahan; Tristram D Bahnson; Douglas L Packer; Richard A Robb Journal: Comput Methods Programs Biomed Date: 2014-11-13 Impact factor: 5.428
Authors: Sachin S Parikh; Christian Jons; Scott McNitt; James P Daubert; Karl Q Schwarz; Burr Hall Journal: Pacing Clin Electrophysiol Date: 2010-02-01 Impact factor: 1.976
Authors: M Haïssaguerre; P Jaïs; D C Shah; A Takahashi; M Hocini; G Quiniou; S Garrigue; A Le Mouroux; P Le Métayer; J Clémenty Journal: N Engl J Med Date: 1998-09-03 Impact factor: 91.245
Authors: Christoph Scharf; Michael Sneider; Ian Case; Aman Chugh; Steve W K Lai; Frank Pelosi; Bradley P Knight; Ella Kazerooni; Fred Morady; Hakan Oral Journal: J Cardiovasc Electrophysiol Date: 2003-02