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JACC. Cardiovascular Interventions Aug 2018
Topics: Atrial Fibrillation; Catheter Ablation; Humans; Pulmonary Veins; Stenosis, Pulmonary Vein; Treatment Outcome
PubMed: 30139472
DOI: 10.1016/j.jcin.2018.06.010 -
Circulation. Arrhythmia and... Apr 2018
Topics: Animals; Catheter Ablation; Pulmonary Veins; Swine
PubMed: 29654135
DOI: 10.1161/CIRCEP.118.006378 -
Journal of Cardiovascular... Feb 2022
Topics: Catheter Ablation; Humans; Pulmonary Veins
PubMed: 34910351
DOI: 10.1111/jce.15320 -
Circulation. Cardiovascular... Jun 2022
Topics: Heart Defects, Congenital; Humans; Pulmonary Atresia; Pulmonary Veins; Treatment Outcome
PubMed: 35727879
DOI: 10.1161/CIRCINTERVENTIONS.122.012172 -
Journal of Cardiovascular... Feb 2018
Topics: Atrial Fibrillation; Catheter Ablation; Heart Atria; Humans; Pulmonary Veins
PubMed: 29281756
DOI: 10.1111/jce.13407 -
Pulmonary vein stenosis after HotBalloon pulmonary vein isolation of paroxysmal atrial fibrillation.Heart and Vessels Nov 2021HotBalloon-based pulmonary vein isolation (HBPVI) has yielded encouraging clinical results in the treatment of paroxysmal atrial fibrillation (PAF). However, pulmonary...
HotBalloon-based pulmonary vein isolation (HBPVI) has yielded encouraging clinical results in the treatment of paroxysmal atrial fibrillation (PAF). However, pulmonary vein (PV) stenosis remains a concern. The influence of longer application duration on PV stenosis has not yet been systematically evaluated. All patients who underwent first HBPVI of PAF with pre- and post-ablation computed tomography (CT) were included. We used single-shot technique with application duration of 180 s in the RSPV, 180-240 s in the LSPV, and 120 s in the lower PV procedures. PV stenosis was analyzed using CT and categorized as moderate (50-70%), and severe (> 70%) reduction in PV diameter. We analyzed imaging of the PV anatomy before ablation and during follow-up in 84 patients. Among them, 7 (8.3%) showed moderate stenosis, and 3 (3.6%) had severe stenosis including one total occlusion patient. All severe stenosis and total occlusion occurred in RSPV and LSPV procedures with longer application duration. No severe stenosis nor total PV occlusion occurred in inferior PV procedures with shorter application duration. The incidence of PV stenosis ≥ 50% or total PV occlusion was significantly lower in inferior PV than RSPV and LSPV procedures (0.6%, 6.0%, 8.0%, p = 0.01, respectively). All cases of PV stenosis including total PV occlusion patients were asymptomatic. No intervention for PV stenosis was performed. The risk of PV stenosis in HBPVI was rare in lower PV procedure with shorter application duration. An application duration setting of 120 s in lower PV procedure might be effective to prevent PV stenosis.
Topics: Atrial Fibrillation; Catheter Ablation; Constriction, Pathologic; Humans; Pulmonary Veins; Stenosis, Pulmonary Vein; Treatment Outcome
PubMed: 33929574
DOI: 10.1007/s00380-021-01862-7 -
Heart Rhythm Mar 2017
Topics: Atrial Fibrillation; Catheter Ablation; Humans; Pulmonary Veins; Treatment Outcome
PubMed: 27940125
DOI: 10.1016/j.hrthm.2016.12.007 -
JACC. Clinical Electrophysiology Jun 2022Thirty-eight patients had assessment of pulmonary vein occlusion with the dielectric mapping system and injection of saline as an alternative to contrast. Contrast... (Review)
Review
Thirty-eight patients had assessment of pulmonary vein occlusion with the dielectric mapping system and injection of saline as an alternative to contrast. Contrast injection was required to ascertain pulmonary vein occlusion in 31.6% (12 of 38) of subjects and 17.4% (27 of 155) of veins. No contrast was required in the last 13 subjects. In this single center study, a novel mapping-guided cryoablation approach appeared to minimize the use of contrast in pulmonary vein isolation for the treatment of atrial fibrillation.
Topics: Atrial Fibrillation; Cryosurgery; Feasibility Studies; Humans; Pulmonary Veins; Pulmonary Veno-Occlusive Disease; Treatment Outcome
PubMed: 35738857
DOI: 10.1016/j.jacep.2022.04.011 -
Radiographics : a Review Publication of... 2017The pulmonary veins carry oxygenated blood from the lungs to the heart, but their importance to the radiologist extends far beyond this seemingly straightforward... (Review)
Review
The pulmonary veins carry oxygenated blood from the lungs to the heart, but their importance to the radiologist extends far beyond this seemingly straightforward function. The anatomy of the pulmonary veins is variable among patients, with several noteworthy variant and anomalous patterns, including supernumerary pulmonary veins, a common ostium, anomalous pulmonary venous return, and levoatriocardinal veins. Differences in pulmonary vein anatomy and the presence of variant or anomalous anatomy can be of critical importance, especially for preoperative planning of pulmonary and cardiac surgery. The enhancement or lack of enhancement of the pulmonary veins can be a clue to clinically important disease, and the relationship of masses to the pulmonary veins can herald cardiac invasion. The pulmonary veins are also an integral part of thoracic interventions, including lung transplantation, pneumonectomy, and radiofrequency ablation for atrial fibrillation. This fact creates a requirement for radiologists to have knowledge of the pre- and postoperative imaging appearances of the pulmonary veins. Many of these procedures are associated with important potential complications involving the pulmonary veins, for which diagnostic imaging plays a critical role. A thorough knowledge of the pulmonary veins and a proper radiologic approach to their evaluation is critical for the busy radiologist who must incorporate the pulmonary veins into a routine "search pattern" at computed tomography (CT) and magnetic resonance imaging. This article is a comprehensive CT-based imaging review of the pulmonary veins, including their embryology, anatomy (typical and anomalous), surgical implications, pulmonary vein thrombosis, pulmonary vein stenosis, pulmonary vein pseudostenosis, and the relationship of tumors to the pulmonary veins. Online supplemental material is available for this article. RSNA, 2017.
Topics: Anatomic Variation; Contrast Media; Humans; Patient Care Planning; Preoperative Care; Pulmonary Veins; Tomography, X-Ray Computed
PubMed: 29131765
DOI: 10.1148/rg.2017170050 -
Pediatric Radiology Dec 2022Newer-generation CT scanners with ultrawide detectors or dual sources offer millisecond image acquisition times and significantly decreased radiation doses compared to... (Review)
Review
Newer-generation CT scanners with ultrawide detectors or dual sources offer millisecond image acquisition times and significantly decreased radiation doses compared to historical cardiac CT and CT angiography. This technology is capable of nearly freezing cardiac and respiratory motion. As a result, CT is increasingly used for diagnosing and monitoring cardiac and vascular abnormalities in the pediatric population. CT is particularly useful in the setting of pulmonary vein evaluation because it offers evaluation of the entire pulmonary venous system and lung parenchyma. In this article we review a spectrum of congenital and acquired pulmonary venous abnormalities, including potential etiologies, CT imaging findings and important factors of preoperative planning. In addition, we discuss optimization of CT techniques for evaluating the pulmonary veins.
Topics: Child; Humans; Pulmonary Veins; Tomography, X-Ray Computed; Computed Tomography Angiography
PubMed: 34734315
DOI: 10.1007/s00247-021-05208-3