Periprocedural imaging and outcomes after catheter ablation of atrial fibrillation

Steinberg, Benjamin A.; Hammill, Bradley G.; Daubert, James P.; Bahnson, Tristram D.; Douglas, Pamela S.; Qualls, Laura G.; Pokorney, Sean D.; Calkins, Hugh; Curtis, Lesley H.; Piccini, Jonathan P.

doi:10.1136/heartjnl-2014-306067

Cited by 21 publications

(15 citation statements)

References 20 publications

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“…An integrated 3D scar reconstruction from delayed gadolinium-enhanced MR imaging was used to facilitate ventricular tachycardia ablation [82] and to confirm/deny the presence of scar after the intervention. Furthermore, there has been increasing interest in visualizing the immediate post ablation injury to better understand its effect on left atrium remodeling and the success of the procedure [83]. Within 24 hours after ablation, dark regions of no-reflow on contrast enhanced MR imaging have been used to correlate with regions of myocardium that eventually become scarred [84,85].…”

Section: Appearance Of Treated Tissues On Mr Imagingmentioning

confidence: 99%

Potentials, Limitations and Future Directions of MR Contrast Media in Ablation Therapies

Saeed¹,

Liang²,

Hetts³

et al. 2016

Journal of Advances in Radiology and Medical Imaging

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Section: Appearance Of Treated Tissues On Mr Imagingmentioning

confidence: 99%

Potentials, Limitations and Future Directions of MR Contrast Media in Ablation Therapies

Saeed¹,

Liang²,

Hetts³

et al. 2016

Journal of Advances in Radiology and Medical Imaging

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“…79 They found that use of preprocedural cardiac CT/MR was associated with a lower risk of TIA/stroke at 6 months (0.4% vs 0.9%, adjusted HR 0.46). Use of ICE was found to be associated with higher risk of bleeding (1.1% vs 0.7%, adjusted HR 1.76), but also with a lower incidence of repeat ablation (5.7% vs 8.5%, adjusted HR 0.68).…”

Section: Peri-procedural Imaging In Catheter Ablationmentioning

confidence: 99%

“…Figure 7 Temporal trends of imaging usage before (CT, MRI, TOE) and during (ICE) ablation. 79 ICE, intracardiac echocardiography.…”

Section: Anticoagulation For Stroke Prevention Which Antithrombotic Tmentioning

confidence: 99%

Almanac 2015: atrial fibrillation research in Heart

Jawad-Ul-Qamar¹,

Kirchhof²

2016

Cardiol Croat.

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Atrial fibrillation continues to attract interest in the cardiovascular community and in Heart. Over 60 original research and review papers published in Heart in 2014-2015 cover various aspects of atrial fibrillation, from associated conditions and precipitating factors to new approaches to management. Here, we provide an overview of articles on atrial fibrillation published in Heart in 2014-2015, highlighting new developments, emerging concepts and novel approaches to treatment.

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“…11 The clear benefit of ICE over 3DRA is that it allows continuous realtime visualisation of geometry and catheter …”

Section: Intracardiac Echocardiographymentioning

confidence: 99%

Three-dimensional Rotational Angiography as a Periprocedural Imaging Tool in Atrial Fibrillation Ablation

Potter

Bardhaj

Viggiano

et al. 2014

Arrhythm Electrophysiol Rev

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Percutaneous catheter treatment for atrial fibrillation (AF) has seen an exponential uptake since the first cases were published exactly two decades ago.1 Evolving over different approaches and treatment strategies, current standard of care consists of pulmonary vein isolation (PVI) through radiofrequency (RF) or other energy sources. While this treatment has been shown to be superior to pharmacological treatment in the setting of paroxysmal AF, considerable variation in reported outcomes exists.2,3 Part of this variation is attributed to the aforementioned change in strategies over time -a clear evolution exists from electrophysiology (EP)-guided (and anatomically rather straightforward) approaches such as trigger elimination inside the pulmonary veins (PVs) to more empirical creation of circular lesions around the PVs.3 This latter approach eliminates challenges such as trigger identification and reduces safety concerns such as PV stenosis, but introduces new complexities that are mostly related to catheter positioning in the complex three-dimensional (3D) space of the left atrium (LA).One of the peculiarities of catheter manipulation in the LA is the usefulness, or rather lack of usefulness, of basic two-dimensional (2D) fluoroscopy. Unlike conventional procedures (e.g. right atrial or ventricular manipulation), fluoroscopy landmarks for AF ablation are few and far between. On top of that, safe and successful PVI requires precise energy delivery at crucial complex 3D structures, such as the left superior PV left atrial appendage transition. In order to achieve this goal, several tools have been developed that either help the operator understand anatomy, facilitate 3D catheter navigation or decrease radiation exposure; and ideally combine several of these useful features. 4-7 Rotational AngiographyThree-dimensional rotational angiography (3DRA) is an innovative method that allows reconstruction of tomographic slices of a volume of interest in a manner similar to computed tomography (CT), using single-plane radiographic equipment. 8,9 The reconstructed 3D models can be used instead of conventional CT or magnetic resonance imaging (MRI) to complement non-fluoroscopic navigation systems, or can be overlaid on 2D fluoroscopic images. In contrast to CT/MRI this technology allows near realtime 3D imaging that is acquired during an ongoing ablation procedure, thereby avoiding volume mismatch due to changes in volume status, rhythm or even table geometry (influencing chest geometry). Not only does 3DRA offer advantages in terms of accuracy over pre-procedural imaging, it also has important benefits from a logistics and cost-effectiveness perspective. Table 1 lists the impact of 3DRA in different clinical scenarios, explained below. Table 2 lists the impact of different workflow options for 3DRA. Three-dimensional Rotational Angiography as Computed Tomography SubstituteAt its core, 3DRA is a technology that produces CT-like tomography slices.These slices can be used to perform measurements or -more commonly for EP pr...

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Periprocedural imaging and outcomes after catheter ablation of atrial fibrillation

Cited by 21 publications

References 20 publications

Potentials, Limitations and Future Directions of MR Contrast Media in Ablation Therapies

Potentials, Limitations and Future Directions of MR Contrast Media in Ablation Therapies

Almanac 2015: atrial fibrillation research in Heart

Three-dimensional Rotational Angiography as a Periprocedural Imaging Tool in Atrial Fibrillation Ablation

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