| Role of Transesophageal Echocardiography Compared to Computed Tomography in Evaluation of Pulmonary Vein Ablation for Atrial Fibrillation (ROTEA Study). | |
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MedLine Citation:
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PMID: 21723708 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND: Computed tomography (CT) is the gold standard for assessing pulmonary vein (PV) anatomy and stenosis after ablation for atrial fibrillation (AF), but radiation exposure can be a concern. Transesophageal echocardiography (TEE) provides anatomic and functional assessment of the PVs, although no study has prospectively compared findings on TEE with those on CT. METHODS: The Role of Transesophageal Echocardiography Compared to Computed Tomography in Evaluation of Pulmonary Vein Ablation for Atrial Fibrillation (ROTEA) study was a prospective, single-blinded observational study of patients with paroxysmal or persistent AF undergoing ablation. TEE and CT were performed immediately before and 3 months after AF ablation. The study included 43 patients (84% men; mean age, 56 ± 11 years). RESULTS: In the preprocedural study, TEE identified 98% of PVs with adequate Doppler measurements obtained. After ablation, no moderate or severe PV stenosis was detected on CT, and a 30% to 50% reduction in luminal diameter was seen in 5% of studied veins. Functional PV stenosis by pulsed-wave Doppler was seen in two veins on TEE. PV diameters decreased after ablation by 0.20 ± 0.03 and 0.22 ± 0.03 cm as measured by CT and TEE, respectively (P < .001). However, TEE underestimated PV ostial dimensions compared with CT, especially for the inferior PVs. Severe spontaneous echo contrast and low left atrial appendage emptying velocities, were identified in 10% of patients in sinus rhythm after ablation. CONCLUSIONS: In the ROTEA study, TEE was feasible in assessing PVs before and after ablation, providing both anatomic and functional information that complemented CT. PV ostial dimensions after ablation can be monitored using either modality, although TEE underestimates PV dimensions, especially for the inferior veins. |
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Authors:
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Andrew C Y To; Ruvin S Gabriel; Margaret Park; Boris S Lowe; Ronan J Curtin; Gardar Sigurdsson; Minerva Sherman; Oussama M Wazni; Walid I Saliba; Mandeep Bhargava; Bruce D Lindsay; Allan L Klein |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-6-30 |
Journal Detail:
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Title: Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography Volume: - ISSN: 1097-6795 ISO Abbreviation: - Publication Date: 2011 Jun |
Date Detail:
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Created Date: 2011-7-4 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8801388 Medline TA: J Am Soc Echocardiogr Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2011 American Society of Echocardiography. Published by Mosby, Inc. All rights reserved. |
Affiliation:
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Cleveland Clinic, Cleveland, Ohio. |
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