Prospective randomized comparison of rotational angiography with three-dimensional reconstruction and computed tomography merged with electro-anatomical mapping: a two center atrial fibrillation ablation study

Anand, Rishi; Горев, М. В.; Poghosyan, Hermine; Pothier, Lindsay; MAtkins, J; Kotler, Gregory; Moroz, Sarah; Armstrong, James; Nemtsov, S.V.; Orlov, Michael V.

doi:10.1007/s10840-016-0111-z

Cited by 4 publications

(2 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The present demographic scenario is reflected by the number of individuals referred to PVI by EAM-guided catheter ablation [13]. Compensating for LA/PVs anatomical variability [14], which might reduce therapy efficacy and increase procedural time, different imaging modalities have been used to facilitate RFA procedures [4,[15][16][17] including CT. Currently, CT scanners with excellent spatial resolution are widely distributed and could be helpful for detailed pre-procedural planning in cardiac electrophysiology.…”

Section: Discussionmentioning

confidence: 99%

“…Structural variabilities of the left atrium (LA) and pulmonary veins (PVs) can include LA enlargement, thepresence of LA diverticulum, additional PVs with variant anatomy of the ostia (observed in 40% of patients undergoing ablation) [1], and early-branching [2,3]. Thus, it is convenient to support electroanatomic mapping (EAM)-guided radiofrequency ablation (RFA) procedures with additional imaging of the LA, such as 3D computed tomography (CT) [4][5][6][7]. Moreover, cardiac CT allows the assessment of LA appendage for the presence of thrombus further reducing the risk of complications [8].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Reduced Radiation Exposure Protocol during Computer Tomography of the Left Atrium Prior to Catheter Ablation in Patients with Atrial Fibrillation

et al. 2022

View full text Add to dashboard Cite

(1) Background: Computer tomography (CT) is an imaging modality used in the pre-planning of radiofrequency catheter ablation (RFA) procedure in patients with cardiac arrhythmias. However, it is associated with a considerable ionizing radiation dose for patients. This study aims to develop and validate low-dose CT scanning protocols of the left atrium (LA) for RFA guidance. (2) Methods: 68 patients scheduled for RFA of atrial fibrillation were sequentially assigned to four groups of ECG-gated scanning protocols, based on the set tube current (TC): Group A (n = 20, TC = 33 mAs), Group B (n = 18, TC = 67 mAs), Group C (n = 10, TC = 135 mAs), and control Group D (n = 20, TC = 600 mAs). We used a 256-row multidetector CT with body weight-dependent tube voltage of 80 kVp (<70 kg), 100 kVp (70–90 kg), and 120 kVp (>90 kg). We evaluated scanning parameters including radiation dose, total scanning procedure time and signal-to-noise ratio (SNR). (3) Results: The average effective radiation dose (ED) was lower in Group A in comparison to Group B, C and D (0.83 (0.76–1.10), 1.55 (1.36–1.67), 2.91 (2.32–2.96) and 9.35 (8.00–10.04) mSv, p < 0.05). The total amount of contrast media was not significantly different between groups. The mean SNR was 6.5 (5.8–7.3), 7.1 (5.7–8.2), 10.8 (10.1–11.3), and 12.2 (9.9–15.7) for Group A, B, C and D, respectively. The comparisons of SNR in group A vs. B and C vs. D were without significant differences. (4) Conclusions: Optimized pre-ablation CT scanning protocols of the LA can reduce an average ED by 88.7%. Three dimensional (3D) models created with the lowest radiation protocol are useful for the integration of electro-anatomic-guided RFA procedures.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Reduced Radiation Exposure Protocol during Computer Tomography of the Left Atrium Prior to Catheter Ablation in Patients with Atrial Fibrillation

et al. 2022

View full text Add to dashboard Cite

show abstract

The seamless integration of three-dimensional rotational angiography images into electroanatomical mapping systems to guide catheter ablation of atrial fibrillation

et al. 2018

View full text Add to dashboard Cite

It is important to visually confirm radiofrequency ablation lesions during atrial fibrillation (AF) ablation for procedural efficiency, which requires the integration of a three-dimensional (3D) left atrial image reconstructed from computed tomography (CT) or a magnetic resonance imaging. However, an EP Navigator allows seamless integration of 3D anatomy obtained through 3D rotational angiography (3D-ATG) into an electroanatomical mapping system. We hypothesized that 3D-ATG can be used during AF ablation while significantly reducing the effective dose (ED) and without compromising image morphology compared to a 3D-CT image. Organ dose was measured at 37 points with a radiophotoluminescence glass dosimeter inserted in an anthropomorphic Rando Phantom. The ED was calculated by multiplying the organ dose by the tissue weighting factor. The dose-area product (DAP)-to-ED conversion factor was calculated by measuring the DAP during radiation exposure. The ED for the CT examination was estimated from the dose-length product with a conversion factor of 0.014. ED was calculated from DAP measurements in 114 patients undergoing AF ablation using 3D-ATG. The DAP-to-ED conversion factor for 3D-ATG was 2.4 × 10 mSv/mGy cm in our hospital. The mean DAP for all patients was 7777 ± 1488 mGy cm for the 3D-ATG of the left atrium. The corresponding ED for 3D-ATG was 1.9 ± 0.4 mSv. The ED for CT examinations was 13.6 ± 4.2 mSv (P < 0.001). 3D-ATG can be used during AF ablation while significantly reducing the ED and without compromising image morphology.

show abstract

Intra-procedural three-dimensional rotational angiography in cryoballoon ablation for atrial fibrillation

Velagić

Mugnai

Kardum

et al. 2020

Int J Cardiovasc Imaging

View full text Add to dashboard Cite

Prospective randomized comparison of rotational angiography with three-dimensional reconstruction and computed tomography merged with electro-anatomical mapping: a two center atrial fibrillation ablation study

Abstract: This study did not find superiority of 3DATG-EAM image merge to guide AF ablation when compared to CT-EAM fusion. Both merging techniques result in similar navigation accuracy.

Cited by 4 publications

References 19 publications

Reduced Radiation Exposure Protocol during Computer Tomography of the Left Atrium Prior to Catheter Ablation in Patients with Atrial Fibrillation

Reduced Radiation Exposure Protocol during Computer Tomography of the Left Atrium Prior to Catheter Ablation in Patients with Atrial Fibrillation

The seamless integration of three-dimensional rotational angiography images into electroanatomical mapping systems to guide catheter ablation of atrial fibrillation

Intra-procedural three-dimensional rotational angiography in cryoballoon ablation for atrial fibrillation

Contact Info

Product

Resources

About