open access

Vol 28, No 4 (2021)
Original Article
Submitted: 2019-07-03
Accepted: 2019-11-03
Published online: 2019-12-09
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Optimal timing of contrast-enhanced three-dimensional magnetic resonance left atrial angiography before pulmonary vein ablation

Susanne Löbe1, Claudia Leuthäusser1, Alexander Pölkow1, Sebastian Hilbert1, Philipp Sommer1, Andreas Bollmann1, Gerhard Hindricks12, Ingo Paetsch1, Cosima Jahnke1
DOI: 10.5603/CJ.a2019.0112
·
Pubmed: 31909472
·
Cardiol J 2021;28(4):558-565.
Affiliations
  1. Leipzig Heart Institute, Leipzig, Germany
  2. Leipzig Heart Institute, Leipzig, Germany

open access

Vol 28, No 4 (2021)
Original articles — Clinical cardiology
Submitted: 2019-07-03
Accepted: 2019-11-03
Published online: 2019-12-09

Abstract

Background: To achieve high image quality of cardiovascular magnetic resonance (CMR) pulmonary vein (PV) angiography prior catheter ablation in patients with atrial fibrillation, optimal timing of the angiographic sequence during contrast agent passage is important. The present study identified influential cardiovascular parameters for prediction of contrast agent travel time.
Methods: One hundred six consecutive patients underwent a CMR examination including three-dimensional (3D) contrast-enhanced PV angiography with real-time bolus tracking prior to catheter ablation. Correct scan timing was characterized by relative signal enhancement measurements in the pulmonary artery, left atrium (LA), and ascending aorta. Furthermore, left- and right-ventricular function, left- and right-atrial dimensions, presence of mitral or tricuspid insufficiencies, and main pulmonary artery diameter were determined.
Results: The highest relative signal enhancement in LA demonstrated optimal scan timing. Contrast agent travel time showed wide variability (range: 12–42 s; mean: 18 ± 4 s). On univariate analysis, most cardiovascular parameters correlated with contrast agent travel time while on multivariate analysis left- and right-ventricular function remained the only independent predictors, but overall a poor fit to the data (adjusted R2, 27.5%) was found.
Conclusions: Contrast agent travel time was mainly influenced by left- and right-ventricular function but prediction models poorly fitted the data. Thus, 3D PV angiography prior to PV ablation procedures necessitates real-time assessment, with visual determination of individual contrast agent passage time to ensure consistently high CMR image quality.

Abstract

Background: To achieve high image quality of cardiovascular magnetic resonance (CMR) pulmonary vein (PV) angiography prior catheter ablation in patients with atrial fibrillation, optimal timing of the angiographic sequence during contrast agent passage is important. The present study identified influential cardiovascular parameters for prediction of contrast agent travel time.
Methods: One hundred six consecutive patients underwent a CMR examination including three-dimensional (3D) contrast-enhanced PV angiography with real-time bolus tracking prior to catheter ablation. Correct scan timing was characterized by relative signal enhancement measurements in the pulmonary artery, left atrium (LA), and ascending aorta. Furthermore, left- and right-ventricular function, left- and right-atrial dimensions, presence of mitral or tricuspid insufficiencies, and main pulmonary artery diameter were determined.
Results: The highest relative signal enhancement in LA demonstrated optimal scan timing. Contrast agent travel time showed wide variability (range: 12–42 s; mean: 18 ± 4 s). On univariate analysis, most cardiovascular parameters correlated with contrast agent travel time while on multivariate analysis left- and right-ventricular function remained the only independent predictors, but overall a poor fit to the data (adjusted R2, 27.5%) was found.
Conclusions: Contrast agent travel time was mainly influenced by left- and right-ventricular function but prediction models poorly fitted the data. Thus, 3D PV angiography prior to PV ablation procedures necessitates real-time assessment, with visual determination of individual contrast agent passage time to ensure consistently high CMR image quality.

Get Citation

Keywords

cardiovascular magnetic resonance imaging, angiography, pulmonary vein, atrial fibrillation, catheter ablation

About this article
Title

Optimal timing of contrast-enhanced three-dimensional magnetic resonance left atrial angiography before pulmonary vein ablation

Journal

Cardiology Journal

Issue

Vol 28, No 4 (2021)

Article type

Original Article

Pages

558-565

Published online

2019-12-09

Page views

903

Article views/downloads

763

DOI

10.5603/CJ.a2019.0112

Pubmed

31909472

Bibliographic record

Cardiol J 2021;28(4):558-565.

Keywords

cardiovascular magnetic resonance imaging
angiography
pulmonary vein
atrial fibrillation
catheter ablation

Authors

Susanne Löbe
Claudia Leuthäusser
Alexander Pölkow
Sebastian Hilbert
Philipp Sommer
Andreas Bollmann
Gerhard Hindricks
Ingo Paetsch
Cosima Jahnke

References (17)
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