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Relationship of the lungs to the left atrium of particular relevance for ablation of atrial fibrillation
Background Symptoms of possible lung and pleural injury such as chest pain and hemoptysis occur during and after radiofrequency ablation (RFA) and cryoablation (CA) of the left atrium (LA) for treatment of atrial fibrillation (AF). We determined the anatomical relationship of the lungs to the LA wit...
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| Published in: | Journal of interventional cardiac electrophysiology 2017-06, Vol.49 (1), p.21-25 |
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| container_title | Journal of interventional cardiac electrophysiology |
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| creator | Walsh, Katie A. Keane, David Fahy, Gerard J. |
| description | Background
Symptoms of possible lung and pleural injury such as chest pain and hemoptysis occur during and after radiofrequency ablation (RFA) and cryoablation (CA) of the left atrium (LA) for treatment of atrial fibrillation (AF). We determined the anatomical relationship of the lungs to the LA with particular reference to areas commonly targeted during AF ablation.
Methods
Distances from the LA endocardium to the lungs were measured from pre-procedure CT angiograms of 100 consecutive patients (71 males, age 60 ± 8 years) who underwent AF ablation.
Results
In 97% of the patients, the posterior right pulmonary vein antrum was |
| doi_str_mv | 10.1007/s10840-017-0245-7 |
| format | article |
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Symptoms of possible lung and pleural injury such as chest pain and hemoptysis occur during and after radiofrequency ablation (RFA) and cryoablation (CA) of the left atrium (LA) for treatment of atrial fibrillation (AF). We determined the anatomical relationship of the lungs to the LA with particular reference to areas commonly targeted during AF ablation.
Methods
Distances from the LA endocardium to the lungs were measured from pre-procedure CT angiograms of 100 consecutive patients (71 males, age 60 ± 8 years) who underwent AF ablation.
Results
In 97% of the patients, the posterior right pulmonary vein antrum was <5 mm from the lower lobe of the right lung (RLL) over a supero-inferior distance of 3.6 ± 1.5 cm (minimum distance 1.2 ± 0.7 mm). The right inferior pulmonary vein (RIPV) ostium was <5 mm from the RLL in 94% (mean 2.7 ± 1.9 mm). The right superior pulmonary vein ostium was <5 mm from the RLL in 29% (mean 7.1 ± 3.8 mm). The medial segment of the right middle lobe was <5 mm from the carina between right pulmonary veins in 83% (mean 3.6 ± 1.9 mm). The mitral isthmus was <5 mm from the lingula in 5% (mean 9.4 ± 3.6 mm). The inferior lobe of the left lung was <5 mm from the posterior aspect of the ostia of the left inferior and superior pulmonary veins in 9 and 0%, respectively. The bronchi were <5 mm from the LA in 5%.
Conclusions
The lungs are intimately related to sites of the LA commonly targeted during AF RFA. Whether this anatomical proximity translates into clinically significant potential for collateral lung damage during RFA merits further study.]]></description><identifier>ISSN: 1383-875X</identifier><identifier>EISSN: 1572-8595</identifier><identifier>DOI: 10.1007/s10840-017-0245-7</identifier><identifier>PMID: 28357713</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Anatomic Landmarks ; Atrial Fibrillation - diagnostic imaging ; Atrial Fibrillation - surgery ; Cardiology ; Catheter Ablation - adverse effects ; Catheter Ablation - methods ; Female ; Heart Atria - diagnostic imaging ; Heart Atria - injuries ; Heart Injuries - diagnostic imaging ; Heart Injuries - etiology ; Heart Injuries - prevention & control ; Humans ; Lingula ; Lung - diagnostic imaging ; Lung Injury - diagnostic imaging ; Lung Injury - etiology ; Lung Injury - prevention & control ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Organs at Risk - diagnostic imaging ; Reproducibility of Results ; Sensitivity and Specificity ; Tomography, X-Ray Computed - methods</subject><ispartof>Journal of interventional cardiac electrophysiology, 2017-06, Vol.49 (1), p.21-25</ispartof><rights>Springer Science+Business Media New York 2017</rights><rights>Journal of Interventional Cardiac Electrophysiology is a copyright of Springer, 2017.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c405t-7ec294d9098900492d176dd0388ac20b09927416e79937bceb29ac1d2d9c3be93</citedby><cites>FETCH-LOGICAL-c405t-7ec294d9098900492d176dd0388ac20b09927416e79937bceb29ac1d2d9c3be93</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28357713$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Walsh, Katie A.</creatorcontrib><creatorcontrib>Keane, David</creatorcontrib><creatorcontrib>Fahy, Gerard J.</creatorcontrib><title>Relationship of the lungs to the left atrium of particular relevance for ablation of atrial fibrillation</title><title>Journal of interventional cardiac electrophysiology</title><addtitle>J Interv Card Electrophysiol</addtitle><addtitle>J Interv Card Electrophysiol</addtitle><description><![CDATA[Background
Symptoms of possible lung and pleural injury such as chest pain and hemoptysis occur during and after radiofrequency ablation (RFA) and cryoablation (CA) of the left atrium (LA) for treatment of atrial fibrillation (AF). We determined the anatomical relationship of the lungs to the LA with particular reference to areas commonly targeted during AF ablation.
Methods
Distances from the LA endocardium to the lungs were measured from pre-procedure CT angiograms of 100 consecutive patients (71 males, age 60 ± 8 years) who underwent AF ablation.
Results
In 97% of the patients, the posterior right pulmonary vein antrum was <5 mm from the lower lobe of the right lung (RLL) over a supero-inferior distance of 3.6 ± 1.5 cm (minimum distance 1.2 ± 0.7 mm). The right inferior pulmonary vein (RIPV) ostium was <5 mm from the RLL in 94% (mean 2.7 ± 1.9 mm). The right superior pulmonary vein ostium was <5 mm from the RLL in 29% (mean 7.1 ± 3.8 mm). The medial segment of the right middle lobe was <5 mm from the carina between right pulmonary veins in 83% (mean 3.6 ± 1.9 mm). The mitral isthmus was <5 mm from the lingula in 5% (mean 9.4 ± 3.6 mm). The inferior lobe of the left lung was <5 mm from the posterior aspect of the ostia of the left inferior and superior pulmonary veins in 9 and 0%, respectively. The bronchi were <5 mm from the LA in 5%.
Conclusions
The lungs are intimately related to sites of the LA commonly targeted during AF RFA. Whether this anatomical proximity translates into clinically significant potential for collateral lung damage during RFA merits further study.]]></description><subject>Anatomic Landmarks</subject><subject>Atrial Fibrillation - diagnostic imaging</subject><subject>Atrial Fibrillation - surgery</subject><subject>Cardiology</subject><subject>Catheter Ablation - adverse effects</subject><subject>Catheter Ablation - methods</subject><subject>Female</subject><subject>Heart Atria - diagnostic imaging</subject><subject>Heart Atria - injuries</subject><subject>Heart Injuries - diagnostic imaging</subject><subject>Heart Injuries - etiology</subject><subject>Heart Injuries - prevention & control</subject><subject>Humans</subject><subject>Lingula</subject><subject>Lung - diagnostic imaging</subject><subject>Lung Injury - diagnostic imaging</subject><subject>Lung Injury - etiology</subject><subject>Lung Injury - prevention & control</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Organs at Risk - diagnostic imaging</subject><subject>Reproducibility of Results</subject><subject>Sensitivity and Specificity</subject><subject>Tomography, X-Ray Computed - methods</subject><issn>1383-875X</issn><issn>1572-8595</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><recordid>eNqNkU1r3DAQhkVoyG4-fkAvRdBLLk5Gkr3SHMvSJoGFQEggNyHL46yD195KdiD_PjJOSikEqos-5plHEi9jXwVcCAB9GQWYHDIQOgOZF5k-YEtRaJmZAosvaa2MyowuHhfsOMZnAECQqyO2kEYVWgu1ZNs7at3Q9F3cNnve13zYEm_H7inyoZ83VA_cDaEZd1N978LQ-LF1gQdq6cV1nnjdB-7KWTRBE-5aXjdlaNr5-JQd1q6NdPY-n7CHXz_v19fZ5vbqZv1jk_kciiHT5CXmFQIaBMhRVkKvqgqUMc5LKAFR6lysSCMqXXoqJTovKlmhVyWhOmHns3cf-t8jxcHumugpvaKjfoxWGNRK40rBf6BG5mh0bhL6_R_0uR9Dlz4yCYVKA3SixEz50McYqLb70OxceLUC7JSYnROzKTE7JWannm_v5rHcUfWn4yOiBMgZiKnUPVH46-pPrW8FRKBH</recordid><startdate>20170601</startdate><enddate>20170601</enddate><creator>Walsh, Katie A.</creator><creator>Keane, David</creator><creator>Fahy, Gerard J.</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20170601</creationdate><title>Relationship of the lungs to the left atrium of particular relevance for ablation of atrial fibrillation</title><author>Walsh, Katie A. ; Keane, David ; Fahy, Gerard J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c405t-7ec294d9098900492d176dd0388ac20b09927416e79937bceb29ac1d2d9c3be93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Anatomic Landmarks</topic><topic>Atrial Fibrillation - diagnostic imaging</topic><topic>Atrial Fibrillation - surgery</topic><topic>Cardiology</topic><topic>Catheter Ablation - adverse effects</topic><topic>Catheter Ablation - methods</topic><topic>Female</topic><topic>Heart Atria - diagnostic imaging</topic><topic>Heart Atria - injuries</topic><topic>Heart Injuries - diagnostic imaging</topic><topic>Heart Injuries - etiology</topic><topic>Heart Injuries - prevention & control</topic><topic>Humans</topic><topic>Lingula</topic><topic>Lung - diagnostic imaging</topic><topic>Lung Injury - diagnostic imaging</topic><topic>Lung Injury - etiology</topic><topic>Lung Injury - prevention & control</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Organs at Risk - diagnostic imaging</topic><topic>Reproducibility of Results</topic><topic>Sensitivity and Specificity</topic><topic>Tomography, X-Ray Computed - methods</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Walsh, Katie A.</creatorcontrib><creatorcontrib>Keane, David</creatorcontrib><creatorcontrib>Fahy, Gerard J.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of interventional cardiac electrophysiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Walsh, Katie A.</au><au>Keane, David</au><au>Fahy, Gerard J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Relationship of the lungs to the left atrium of particular relevance for ablation of atrial fibrillation</atitle><jtitle>Journal of interventional cardiac electrophysiology</jtitle><stitle>J Interv Card Electrophysiol</stitle><addtitle>J Interv Card Electrophysiol</addtitle><date>2017-06-01</date><risdate>2017</risdate><volume>49</volume><issue>1</issue><spage>21</spage><epage>25</epage><pages>21-25</pages><issn>1383-875X</issn><eissn>1572-8595</eissn><abstract><![CDATA[Background
Symptoms of possible lung and pleural injury such as chest pain and hemoptysis occur during and after radiofrequency ablation (RFA) and cryoablation (CA) of the left atrium (LA) for treatment of atrial fibrillation (AF). We determined the anatomical relationship of the lungs to the LA with particular reference to areas commonly targeted during AF ablation.
Methods
Distances from the LA endocardium to the lungs were measured from pre-procedure CT angiograms of 100 consecutive patients (71 males, age 60 ± 8 years) who underwent AF ablation.
Results
In 97% of the patients, the posterior right pulmonary vein antrum was <5 mm from the lower lobe of the right lung (RLL) over a supero-inferior distance of 3.6 ± 1.5 cm (minimum distance 1.2 ± 0.7 mm). The right inferior pulmonary vein (RIPV) ostium was <5 mm from the RLL in 94% (mean 2.7 ± 1.9 mm). The right superior pulmonary vein ostium was <5 mm from the RLL in 29% (mean 7.1 ± 3.8 mm). The medial segment of the right middle lobe was <5 mm from the carina between right pulmonary veins in 83% (mean 3.6 ± 1.9 mm). The mitral isthmus was <5 mm from the lingula in 5% (mean 9.4 ± 3.6 mm). The inferior lobe of the left lung was <5 mm from the posterior aspect of the ostia of the left inferior and superior pulmonary veins in 9 and 0%, respectively. The bronchi were <5 mm from the LA in 5%.
Conclusions
The lungs are intimately related to sites of the LA commonly targeted during AF RFA. Whether this anatomical proximity translates into clinically significant potential for collateral lung damage during RFA merits further study.]]></abstract><cop>New York</cop><pub>Springer US</pub><pmid>28357713</pmid><doi>10.1007/s10840-017-0245-7</doi><tpages>5</tpages></addata></record> |
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| subjects | Anatomic Landmarks Atrial Fibrillation - diagnostic imaging Atrial Fibrillation - surgery Cardiology Catheter Ablation - adverse effects Catheter Ablation - methods Female Heart Atria - diagnostic imaging Heart Atria - injuries Heart Injuries - diagnostic imaging Heart Injuries - etiology Heart Injuries - prevention & control Humans Lingula Lung - diagnostic imaging Lung Injury - diagnostic imaging Lung Injury - etiology Lung Injury - prevention & control Male Medicine Medicine & Public Health Middle Aged Organs at Risk - diagnostic imaging Reproducibility of Results Sensitivity and Specificity Tomography, X-Ray Computed - methods |
| title | Relationship of the lungs to the left atrium of particular relevance for ablation of atrial fibrillation |
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