Ablation of atrial fibrillation: does the addition of three-dimensional magnetic resonance imaging of the left atrium to electroanatomic mapping improve the clinical outcome?: A randomized comparison of Carto-Merge vs. Carto-XP three-dimensional mapping ablation in patients with paroxysmal and persistent atrial fibrillation

Caponi, Domenico; Corleto, Antonella; Scaglione, Mariano; Blandino, Alessandro; Biasco, Luigi; Cristoforetti, Yvonne; Cerrato, Natascia; Toso, Elisabetta; Morello, Mara; Gaïta, Fiorenzo

doi:10.1093/europace/euq107

Cited by 120 publications

(63 citation statements)

References 24 publications

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“…747,1186,1248,1249 This can only be achieved, however, by an awareness of the importance of reducing fluoroscopy time, and therefore radiation exposure, by the operator. 1250 It has been shown that use of optimized conventional fluoroscopy and optimized use of 3D mapping can result in a marked reduction in radiation exposure.…”

Section: Section 10: Complicationsmentioning

confidence: 99%

2012 HRS/EHRA/ECAS Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation: Recommendations for Patient Selection, Procedural Techniques, Patient Management and Follow-up, Definitions, Endpoints, and Research Trial Design

Calkins,

Kuck,

Cappato

et al. 2012

Heart Rhythm

1,762

1,468

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Section: Section 10: Complicationsmentioning

confidence: 99%

2012 HRS/EHRA/ECAS Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation: Recommendations for Patient Selection, Procedural Techniques, Patient Management and Follow-up, Definitions, Endpoints, and Research Trial Design

Calkins,

Kuck,

Cappato

et al. 2012

Heart Rhythm

1,762

1,468

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“…The end-points of interest were the incidence of in-hospital AF complications, long-term recurrence, multivariate risk for recurrence according to the AF type, and adjusted predictors for recurrence. 5 selection, adjudication, detection, and attrition bias (expressed as low, moderate, or high risk of bias, as well as incomplete reporting leading to the inability to ascertain the underlying risk of bias).…”

Section: Data Extractionmentioning

confidence: 99%

“…Multiple single center randomized studies and multicenter prospective registries comparing anti-arrhythmic drug therapy with TCAFA have shown significantly higher rates of patients in sinus rhythm after an invasive strategy at one year of follow up [1], [2], [3], [4], [5] and [6].…”

Section: Introductionmentioning

confidence: 99%

Which are the most reliable predictors of recurrence of atrial fibrillation after transcatheter ablation?: a meta-analysis

D’Ascenzo

Corleto

Biondi‐Zoccai

et al. 2013

International Journal of Cardiology

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179

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Context Transcatheter ablation of atrial fibrillation (AF) has undergone important development, with acceptable midterm results in terms of the safety and recurrence. A meta-analysis was performed to identify the periprocedural complications, midterm success rates and predictors of recurrence after AF ablation.Methods and results 4357 patients with paroxysmal AF, 1083 with persistent AF and 1777 with long standing AF were included. The pooled analysis showed that there was an in-hospital complication rate of tamponade requiring drainage of 0.99% (0.44-1.54; CI 99%), stroke with neurological persistent impairment of 0.22% (0.04-0.47; CI 99%), and stroke without of 0.36% (0.03-0.70; CI 99%) After a follow up of 22 (13-28) months and 1.23 (1.19-1.5; CI 99%) procedures per patient, the AF recurrence rate was 31. 20% (24.87-34.81; CI 99%). The persistent AF patients exhibited a greater risk of recurrence after the first ablation (OR 1.78 [1.14, 2.77] CI 99%), but a trend towards non significance was present in the patients with more than one procedure (OR 1.69 [0.95,3.00] CI 99%). The most powerful predictors of an AF ablation failure in the overall population were a recurrence within 30-days (OR 4.30; 2.00-10.80), valvular AF (OR 5.20; 2.22-9.50) and a left atrium diameter of more than 50 mm (OR 5.10 2.00-12.90; all CI 95%).Conclusions Persistent AF remains burdened from higher recurrence rates, however not so following redo-procedures. Three predictors, valvular AF, a left atrium diameter longer than 50 mm and recurrence within 30 days, could be appraised to drive selection of patients and therapeutic strategy. Many observational studies have reported predictors identified by multivariate analyses including the time spent in persistent AF, structural heart disease, left ventricular impairment, and, perhaps most consistently, the left atrial diameter [7]; in the case in which they were confirmed in larger datasets these clinical features could be very useful for cardiologists and general clinicians both for a correct selection of patients deferred to an invasive strategy and to accurately manage the following procedure. However, to the best of our knowledge, no meta-analyses have been performed to appraise the results of real life observational studies of AF ablation, and their complication rates and the most powerful predictors of recurrence. 2.MethodsThe present research was elaborated according to current guidelines, including the recent Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) amendment to the Search strategy and study selectionMedline, the Cochrane Library and Biomed Central were searched for related articles, according to the established methods [12], with terms related to catheter ablation of AF and predictors of recurrence obtained through multivariate analyses. All corresponding authors of the studies were directly emailed for further data and suggestions for additional research [13]. All citations at the abstract level were first appraised by independent revie...

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“…Integration of cardiac imaging using MRI and computed tomography was shown to further reduce fluoroscopy exposure during ablation procedure. 1 More recently, a new technology for catheter visualization called the MediGuide technology (St Jude Medical Inc, St Paul, MN) has been introduced that can further facilitate reduction in radiation exposure.…”

mentioning

confidence: 99%

Nonfluoroscopic Catheter Visualization in Atrial Fibrillation Ablation

Sommer

Rolf

Piorkowski

et al. 2014

Circ: Arrhythmia and Electrophysiology

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all patients undergoing AF ablation supported by NFCV technology were included in a prospective registry. In addition to baseline characteristics of patients (age, © 2014 American Heart Association, Inc. . Regression analysis demonstrated a significant decrease of fluoroscopy time, dose, and procedure time. To confirm the result and show overall changes, the initial 50 cases (group 1) to the last 50 cases (group 2) of the series were compared: fluoroscopy time decreased from 6.0 (4.1-10.3) minutes in group 1 to 1.1 (0.7-1.5) minutes in group 2 and radiation dose from 2363 (1413-3475)

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Abstract: Image integration using Carto-Merge in patients undergoing catheter ablation for paroxysmal and persistent AF does not significantly improve the clinical outcome, but shortens the X-ray exposure.

Cited by 120 publications

References 24 publications

2012 HRS/EHRA/ECAS Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation: Recommendations for Patient Selection, Procedural Techniques, Patient Management and Follow-up, Definitions, Endpoints, and Research Trial Design

2012 HRS/EHRA/ECAS Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation: Recommendations for Patient Selection, Procedural Techniques, Patient Management and Follow-up, Definitions, Endpoints, and Research Trial Design

Which are the most reliable predictors of recurrence of atrial fibrillation after transcatheter ablation?: a meta-analysis

Nonfluoroscopic Catheter Visualization in Atrial Fibrillation Ablation

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