Three-dimensional transesophageal echocardiographic evaluation of pulmonary vein anatomy prior to cryoablation: validation with cardiac CT scan

Cardiovascular Ultrasound

Research

Timea Bianka Papp¹  Csaba Jenei¹  Rudolf Kolozsvari¹  Arnold Peter Raduly¹  Laszlo Tibor Nagy¹  Zoltan Csanadi¹  Reka Urbancsek¹  Agnes Racz¹  Richard Veisz² 

[1]Department of Cardiology, Faculty of Medicine, University of Debrecen, 22 Zsigmond Moricz Boulevard, 4032, Debrecen, Hungary

[2]Department of Radiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary

关键词: Three-dimensional transesophageal echocardiography;    Pulmonary vein imaging;    Computed tomography;    Cryoablation;   

DOI  :  10.1186/s12947-023-00305-9

 received in 2022-11-16, accepted in 2023-04-06,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundAnatomical characteristics of the left atrium and the pulmonary veins (PVs) may be relevant to the success rate of cryoballoon (CB)-ablation for atrial fibrillation (AF). Cardiac computed tomography (CCT) is considered as the gold standard for preablation imaging. Recently, three-dimensional transesophageal echocardiography (3DTOE) has been proposed for preprocedural assessment of cardiac structures relevant to CB-ablation. The accuracy of 3DTOE has not been validated by other imaging modalities.ObjectiveWe prospectively evaluated the feasibility and the accuracy of 3DTOE imaging for the assessment of left atrial and PV structures prior to pulmonary vein isolation (PVI). In addition, CCT was used to validate the measurements obtained with 3DTOE.MethodsPV anatomy of 67 patients (59.7% men, mean age 58.5 ± 10.5 years) was assessed using both 3DTOE and CCT scan prior to PVI with the Arctic Front CB. The following parameters were measured bilaterally: PV ostium area (OA), the major and minor axis diameters of the ostium (a > b) and the width of the carina between the superior and the inferior PVs. In addition, the width of the left lateral ridge (LLR) between the left atrial appendage and the left superior PV. Evaluation of inter-technique agreement was based on linear regression with Pearson correlation coefficient (PCC) and Bland–Altman analysis of biases and limits of agreement.ResultsModerate positive correlation (PCC 0.5–0.7) was demonstrated between the two imaging methods for the right superior PV’s OA and both axis diameters, the width of the LLR and left superior PV (LSPV) minor axis diameter (b) with limits of agreement ˂50% and no significant biases. Low positive or negligible correlation (PCC < 0.5) was found for both inferior PV parameters.ConclusionsDetailed assessment of the right superior PV parameters, LLR and LSPV b is feasible with 3DTOE prior to AF ablation. This 3DTOE measurements demonstrated a clinically acceptable inter-technique agreement with those obtained with CCT.Graphical Abstract

【 授权许可】

CC BY   
© The Author(s) 2023

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