54 year old male with history of atrial fibrillation s/p 2 ablations, recurrent atrial fibrillation; scheduled for repeat ablation. Left VentricleThe left ventricle is normal in size with normal systolic function. The overall LV ejection fraction is 56%. The LVEDV is 119 ml (normal range 142+/-34), the LV end diastolic volume index is 53 ml/m2 (normal range: 74+/-15), the LVESV is 53 ml (normal range 47+/-19) and the LV end systolic volume index is 23 ml/m2 (normal range 25+/-9). The LV mass is 176 g (normal range 164+/-36) and the LV mass index is 78 g/m2 (normal range 85+/-15). There are no regional wall motion abnormalities present. There is no late gadolinium enhancement to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process.There is no LV thrombus. Left AtriumThe left atrium is normal in size. All four pulmonary veins drain normally into the left atrium. There is additionally a right middle pulmonary vein. The dimensions are as below. The esophagus runs posterior to the left superior and inferior pulmonary veins and also near the ostium of the right inferior pulmonary vein. No obvious left atrial appendage thrombus is noted. Left atrial volume: 53mlLeft superior pulmonary vein: 15x13mmLeft inferior pulmonary vein: 23x15mmRight superior pulmonary vein: 12x11mmRight middle pulmonary vein: 8x10mmRight inferior pulmonary vein: 16x12mmRight VentricleThe right ventricle is normal in size with normal systolic function. The overall RV ejection fraction is 51%. The RVEDV is 146 ml (normal range 142+/-31), RV end diastolic volume index is 65 ml/m2 (normal range 82+/-16), the RVESV is 71 ml (normal range 54+/-17), and the RV end systolic volume index is 32 ml/m2 (normal range 31+/-9).Right AtriumThe right atrium is normal in size.Aortic ValveThe aortic valve is trileaflet, opens widely and there is no significant aortic regurgitation.Mitral ValveThe mitral valve opens widely and there is mild mitral regurgitation.Pulmonic ValveThe pulmonic valve opens widely. There is no significant pulmonic regurgitation.Tricuspid ValveThe tricuspid valve opens widely. There is no significant tricuspid regurgitation.AortaThere is a left sided aortic arch with a normal brachiocephalic branching pattern. The aortic root is normal in size.Pulmonary ArteryThe main pulmonary artery is normal in size.Venous AnatomyThe SVC and IVC are normal in size and drain normally into the right atrium.PericardiumThere is no obvious pericardial disease.Extracardiac FindingsThis study is not designed for the specific evaluation of extra-cardiac findings; therefore, the differentiation between artifacts and real extracardiac pathology may be difficult. If clinically indicated, a separate dedicated evaluation should be considered.
1. Normal left atrial size.2. Pulmonary vein anatomy as above. Specifically a right middle pulmonary vein with relatively small ostium is noted.3. Esophagus located posterior to left superior and inferior pulmonary veins but also posterior to right inferior pulmonary vein. 4. Normal left ventricular size and systolic function (LVEF 56%)5. Normal right ventricular size and systolic function (RVEF 51%)6. Image quality was somewhat limited due to patient difficulty with lying still and also with breath holds.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.