First experience of 3D rotational angiography fusion with NavX electroanatomical mapping to guide catheter ablation of atrial fibrillation

Carpen, Mahendra; MAtkins, J; Syros, George; Горев, М. В.; Alikhani, Zoubin; Wylie, John V.; Natan, Shaw R.; Griben, Andre; Hicks, Amy; Armstrong, James; Orlov, Michael V.

doi:10.1016/j.hrthm.2012.11.004

Cited by 14 publications

(14 citation statements)

References 25 publications

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“…Another study investigating clinical outcomes of procedures employing 3D rotational angiography was performed by Carpen et al 12 . This retrospective analysis confirmed that fusion of 3DRA with the electroanatomical mapping system results in reduction of total procedural time and radiation exposure with similar clinical outcome during the follow-up (10±3 months vs. 11.9±5.3 months) compared to procedures without the fusion.…”

Section: Discussionmentioning

confidence: 99%

“…The sample size in our study was larger than both the retrospective and prospective trials reporting on clinical outcomes of AF ablation using 3DRA (ref. 12,24 ). Further confirmation of the retrospective data with a prospective, randomized study is required, but is not ethically justified due to the superiority of 3DRA in reducing radiation exposure documented in a number of studies 6,7,10 .…”

Section: Discussionmentioning

confidence: 99%

“…10,11 ). Another advantage is the possibility of integrating the 3D image from the rotational angiography into the electroanatomical mapping system, which facilitates the execution of AF ablation and reduces the total procedural time and radiation exposure while providing similar clinical outcomes 12 . Previous studies have proven that the fusion of CT or MR image of the left atrium with the electroanatomical map in the Carto-Merge system is beneficial for the clinical outcome of the AF ablation and reduction in fluoroscopic guidance 4,13,14 .…”

Section: Introductionmentioning

confidence: 99%

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Comparison of clinical outcomes and safety of catheter ablation for atrial fibrillation supported by data from CT scan or three-dimensional rotational angiogram of left atrium and pulmonary veins

Lehar¹,

Stárek²,

Jež³

et al. 2015

BIOMED PAP

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Background. Catheter ablation in the left atrium has become a common therapeutic strategy in the management of atrial fibrillation (AF). The high degree of success and safety profile of this procedure is dependent on precise knowledge of the true anatomy in the chamber. This information is imported mostly from cardiac computed tomography. A novel method for imaging the left atrial anatomy is three-dimensional rotational angiography (3DRA). Methods. The aim of our study was to the compare clinical outcome and safety of catheter ablation for atrial fibrillation guided by 3DRA vs. conventional CT scan. One hundred and twenty-five patients referred for AF catheter ablation at St. Anne's University Hospital Brno were included in the retrospective analysis of clinical outcome within the first year after the procedure.Results. There was a close correlation in overall procedural parameters between the groups. The frequency of recurrent episodes of AF (24% in CT-guided group vs. 27% in 3DRA-guided group, P=0.721) as well as the onset of atypical atrial flutter after the procedure (10% vs. 8%, respectively, P=0.731) were similar in both groups. No difference in the number of patients necessitating repeat ablation (5% vs. 5%, P=0.984) was found. Procedural complications of ablations guided by 3DRA were comparable with those guided by CT (2% vs. 3%, respectively, P=0.568). Conclusion. 3DRA has proven to be a safe and simple method for imaging the left atrium and guiding catheter ablation for AF. This approach is anticipated to become a new standard in 3D reconstruction of the left atrium.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Comparison of clinical outcomes and safety of catheter ablation for atrial fibrillation supported by data from CT scan or three-dimensional rotational angiogram of left atrium and pulmonary veins

Lehar¹,

Stárek²,

Jež³

et al. 2015

BIOMED PAP

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“…No published study has paid more attention to this topic. To some extent, this gap in the literature may be because of the small number of patients in each study (11-47 patients) and because these studies lacked a control group of patients with 3DRA of the left atrium without esophagus imaging [4,5,7,9].…”

Section: Catheter Ablation With the Support Of 3dra Of The Left Atriummentioning

confidence: 99%

“…Left atrium isocentering was achieved from the anteroposterior and left lateral X-ray view. An injection of the contrast agent was performed with a standard power injector (Mark V, Medrad Inc., Indianola, PA, USA) [7,9].…”

Section: Introductionmentioning

confidence: 99%

Periprocedural 3D imaging of the left atrium and esophagus: comparison of different protocols of 3D rotational angiography of the left atrium and esophagus in group of 547 consecutive patients undergoing catheter ablation of the complex atrial arrhythmias

Stárek

Lehar

Jež

et al. 2016

Int J Cardiovasc Imaging

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A new method in creating 3D models of the left atrium (LA) and esophagus before catheter ablation of atrial arrhythmias is 3D rotational angiography (3DRA) of the LA. The purpose of this retrospective study was to test various acquisition protocols of the 3DRA and attempt to define the parameters influencing the success of the protocols. From August 2010 to November 2014, 3DRA of the LA using the Philips Allura FD 10 X-ray system was performed in 547 consecutive patients using right atrial and left atrial protocols. Visualization of the esophagus was performed after oral administration of a contrast agent. Patients were monitored for success (creation of a useful 3D models) and evaluated for a number of parameters affecting the success of 3DRA. The success of the RA protocol was 88.89 % with and 91.91 % without esophagus imaging. The success of the LA protocol was 97.42 % with and 94.54 % without esophagus imaging. The only factor reducing the success of the RA protocol was BMI; the LA protocol was not influenced by any factor. Ventricular fibrillation induced in two patients was successfully treated with defibrillation. 3DRA of the LA is a reliable method that supports catheter ablation of complex atrial arrhythmias. The LA protocol with esophagus imaging was significantly more reliable than the RA protocol; the other protocols were comparable. The RA protocol may be negatively affected by high BMI. Simultaneous imaging of the esophagus is safe and feasible, and the LA protocol can be recommended.

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Intra-procedural imaging of the left atrium and pulmonary veins with rotational angiography: a comparison of anatomy obtained by pre-procedural cardiac computed tomography and trans-thoracic echocardiography

Park

Kim

Choi

et al. 2013

Int J Cardiovasc Imaging

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This study evaluated the feasibility and accuracy of three-dimensional rotational angiography (3DRA) to determine the anatomy of the left atrium (LA) and pulmonary veins (PVs) compared with cardiac computed tomography (CCT) and trans-thoracic echocardiography (TTE). One hundred two patients (56.1 ± 9.9 years, 86 males) with an indication for atrial fibrillation ablation were prospectively enrolled. Intra-procedural 3DRA was performed with power injected contrast medium (20 cc/s for 4 s, 240°) in the LA. 3DRA images of the LA and PVs were assessed qualitatively and then compared quantitatively. LA volume measured by 3DRA, CCT and TTE were compared. The majority of 3DRA acquisitions were optimal in delineating the right-side LA-PV (95 % for right superior PV and 96 % for right inferior PV) and left inferior PV anatomy (91 %), whereas it was optimal in only 63 % of left superior PV and 73 % of the LA appendage. The circumferences of PV ostia identified by 3DRA and CCT were correlated in four PVs (r = 0.57 for right superior PV, r = 0.67 for right inferior PV, r = 0.60 for left superior PV, and r = 0.52 for left inferior PV, p < 0.001). The mean LA volume measured by 3DRA (120 ± 32 mL) was greater than that found by CCT (109 ± 35 mL) or TTE (64 ± 23 mL), but the 3DRA LA volume measurements correlated well with those of CCT (r = 0.83, p < 0.001) and TTE (r = 0.69, p < 0.001). Intra-procedural 3DRA provided anatomical accuracy of LA and PVs comparable to those of CCT. However, optimal delineation of the left superior PV and LA appendage was limited. The LA volume determined by 3DRA was well correlated with those of CCT and TTE, despite different absolute values of each.

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First experience of 3D rotational angiography fusion with NavX electroanatomical mapping to guide catheter ablation of atrial fibrillation

Cited by 14 publications

References 25 publications

Comparison of clinical outcomes and safety of catheter ablation for atrial fibrillation supported by data from CT scan or three-dimensional rotational angiogram of left atrium and pulmonary veins

Comparison of clinical outcomes and safety of catheter ablation for atrial fibrillation supported by data from CT scan or three-dimensional rotational angiogram of left atrium and pulmonary veins

Periprocedural 3D imaging of the left atrium and esophagus: comparison of different protocols of 3D rotational angiography of the left atrium and esophagus in group of 547 consecutive patients undergoing catheter ablation of the complex atrial arrhythmias

Intra-procedural imaging of the left atrium and pulmonary veins with rotational angiography: a comparison of anatomy obtained by pre-procedural cardiac computed tomography and trans-thoracic echocardiography

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