title: Magnetic resonance imaging versus computed tomography for characterization of pulmonary vein morphology before radiofrequency catheter ablation of atrial fibrillation.
abstract: The accurate assessment of pulmonary vein (PV) anatomy is important in planning radiofrequency catheter ablation (RFCA) of atrial fibrillation (AF). The aim of the present study was to perform a head-to-head comparison of magnetic resonance imaging (MRI) and multislice computed tomography (CT) for the evaluation of PV morphology before RFCA of AF. Contrast-enhanced MRI (on a 1.5-T system) and multislice CT (on a dual-source system) were performed for the evaluation of the PVs in 44 consecutive patients (31 men, mean age 56 +/- 10 years) admitted for RFCA of drug-refractory AF. Data on PV anatomy, ostial branching pattern, and ostial dimensions were compared between MRI and multislice CT. Variant PV anatomy was observed in 21 patients (48%) with the 2 imaging approaches. The incidence of PV ostial branching, as assessed with MRI and multislice CT, was higher on the right and more common in the inferior than superior vein. Agreement between the 2 imaging modalities for the evaluation of variant PV anatomy (kappa = 0.87, 95% confidence interval 0.77 to 0.97) and ostial branching pattern (kappa = 0.84, 95% confidence interval 0.75 to 0.93) was nearly perfect. Assessment of PV ostial cross-sectional area as well as maximal and minimal ostial diameters resulted in strong agreement and correlation (r(2) = 0.75 to 0.99, p <0.001 for all) between the 2 imaging approaches. In conclusion, MRI and multislice CT of the PVs appear to provide similar and detailed anatomic and quantitative information before RFCA of AF.
authors.affiliation: Department of Internal Medicine/Cardiology, German Heart Institute Berlin, Berlin, Germany.
authors.forename: Ashraf
authors.initials: A
authors.lastname: Hamdan
authors.forename: Kriatselis
authors.initials: K
authors.lastname: Charalampos
authors.forename: Rainer
authors.initials: R
authors.lastname: Roettgen
authors.forename: Ernst
authors.initials: E
authors.lastname: Wellnhofer
authors.forename: Rolf
authors.initials: R
authors.lastname: Gebker
authors.forename: Ingo
authors.initials: I
authors.lastname: Paetsch
authors.forename: Cosima
authors.initials: C
authors.lastname: Jahnke
authors.forename: Bernhard
authors.initials: B
authors.lastname: Schnackenburg
authors.forename: Min
authors.initials: M
authors.lastname: Tang
authors.forename: Hong
authors.initials: H
authors.lastname: Gerds-Li
authors.forename: Eckart
authors.initials: E
authors.lastname: Fleck
mesh_terms: D000328:Adult; D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000601:surgery*; D017115:Catheter Ablation; D015331:Cohort Studies; D003287:Contrast Media; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011300:Preoperative Care; D011667:Pulmonary Veins / Q000000981:diagnostic imaging* / Q000473:pathology*; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed
chemical_list: D003287:Contrast Media