Jeremy N. Ruskin

Integration of Cardiac CT/MR Imaging with Three‐Dimensional Electroanatomical Mapping to Guide Catheter Manipulation in the Left Atrium: Implications for Catheter Ablation of Atrial Fibrillation

Introduction: Preprocedural cardiac imaging (CT/MRI) and intraprocedural electroanatomical mapping (EAM) are commonly used during left atrial (LA) catheter ablation of atrial fibrillation (AF). In the optimal scenario, the imaging datasets would be directly integrated with the EAM system to guide catheter mapping based on the accurate individual cardiac anatomy.

Pericardial Anatomy for the Interventional Electrophysiologist

Investigators are beginning to exploit the pericardial space for a number of cardiovascular applications, including catheter ablation of cardiac arrhythmias, cardiovascular drug therapy, and cardiac pacing. This review explores the anatomy of the pericardial space and the anatomic variants that may be encountered in this novel approach to the heart. (J Cardiovasc Electrophysiol, Vol. 14, pp. 422‐430, April 2003)

Intraprocedural Volume Imaging of the Left Atrium and Pulmonary Veins with Rotational X-Ray Angiography: Implications for Catheter Ablation of Atrial Fibrillation

Introduction: The use of preprocedural CT or MR imaging to generate patient‐specific cardiac anatomy greatly facilitates catheter ablation of the left atrium and pulmonary veins (LA‐PVs) to treat atrial fibrillation (AF). This report details the accuracy and utility of an intraprocedural means to generate 3‐D volumetric renderings of the LA‐PV anatomy: contrast‐enhanced rotational X‐ray angiography (3DRA).

Three‐Dimensional Anatomy of the Left Atrium by Magnetic Resonance Angiography: Implications for Catheter Ablation for Atrial Fibrillation

Background: Pulmonary vein isolation (PVI) has become one of the primary treatments for symptomatic drug‐refractory atrial fibrillation (AF). During this procedure, delivery of ablation lesions to certain regions of the left atrium can be technically challenging. Among the most challenging regions are the ridges separating the left pulmonary veins (LPV) from the left atrial appendage (LAA), and the right middle pulmonary vein (RMPV) from the right superior (RSPV) and right inferior (RIPV) pulmonary veins. A detailed anatomical characterization of these regions has not been previously reported.

Left atrial appendage dimensions predict the risk of stroke/TIA in patients with atrial fibrillation.

Risk of Stroke/TIA in Patients With Atrial Fibrillation. Introduction: Most strokes in patients with atrial fibrillation (AF) arise from thrombus formation in left atrial appendage (LAA). Our aim was to identify LAA features associated with a higher stroke risk in patients with AF using magnetic resonance imaging and angiography (MRI/MRA).

Experimental Efficacy of Pericardial Instillation of Anti‐inflammatory Agents during Percutaneous Epicardial Catheter Ablation to Prevent Postprocedure Pericarditis

Introduction: Pericarditis is a potential complication of catheter‐based percutaneous epicardial mapping and ablation. This study evaluates the efficacy and safety of intrapericardial instillation of anti‐inflammatory agents after pericardial mapping and ablation in a porcine model of postprocedural pericarditis.

Three-Dimensional Analysis of Pulmonary Venous Ostial and Antral Anatomy: Implications for Balloon Catheter-Based Pulmonary Vein Isolation

Background: Balloon ablation catheters using various energy sources are being developed to perform pulmonary vein (PV) isolation to treat atrial fibrillation. Prior evaluations of 2D CT/MR images are limited by the frequent elliptical shape of the PV ostia, the nonorthogonal orientation of the PVs to the left atrial (LA) chamber, and difficulty in appreciating through‐slice curvature. To provide anatomical data relevant to balloon catheter ablation, 3D surface reconstructions of LA‐PVs were generated and analyzed to define ostial architecture and size.

Pain and Anatomical Locations of Radiofrequency Ablation as Predictors of Esophageal Temperature Rise During Pulmonary Vein Isolation

Introduction: Esophageal temperature rise (ETR) during ablation inside left atrium has been reported as a marker for esophageal thermal injury. We sought to investigate the possible relationships between chest pain and ETR during radiofrequency (RF) ablation, and ETR and locations of RF application, in patients undergoing pulmonary vein (PV) isolation under moderate sedation.

Multi-sensor esophageal temperature probe used during radiofrequency ablation for atrial fibrillation is associated with increased intraluminal temperature detection and increased risk of esophageal injury compared to single-sensor probe.

Radiofrequency (RF) ablation in the posterior left atrium has risk of thermal injury to the adjacent esophagus. Increased intraluminal esophageal temperature has been correlated with risk of esophageal injury. The objective of this study was to compare esophageal temperature monitoring (ETM) using a multi‐sensor temperature probe with 12 sensors to a single‐sensor probe during catheter ablation for atrial fibrillation (AF).

Focal and Linear Endocardial and Epicardial Catheter-Based Cryoablation of Normal and Infarcted Ventricular Tissue

Background: This study of a chronic porcine postinfarction model examined whether linear epicardial cryoablation was capable of creating large, homogenous lesions in regions of the myocardium including scarred ventricle. Endocardial and epicardial focal cryolesions were also compared to determine if there were significant differences in lesion characteristics.