Three-dimensional rotational angiography of the left atrium and esophagus—A virtual computed tomography scan in the electrophysiology lab?

Orlov, Michael V.; Hoffmeister, Peter; Chaudhry, Ghulam M.; Almasry, Ibrahim; Gijsbers, G. H. M.; Swack, Tammee; Haffajee, Charles I.

doi:10.1016/j.hrthm.2006.10.003

Cited by 84 publications

(44 citation statements)

References 19 publications

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“…Rotational angiography (3DRA) is an innovative method that allows per-procedural reconstruction of tomographic slices of a volume of interest in a manner similar to CT, using singe plane radiographic equipment [68,69]. These slices can be used to perform measurements in any plane of the 3D volume, or to make a 3D reconstruction of a structure of interest and integrate it with fluoroscopy or other 3D mapping technologies.…”

Section: Rotational Angiographymentioning

confidence: 99%

Role of Imaging in Left Atrial Appendage Occlusion

Lempereur

Aminian

Potter

et al. 2017

ijcp

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Percutaneous left atrial appendage (LAA) occlusion is now a valid alternative to longterm oral anticoagulation in patients with non-valvular atrial fibrillation at high thromboembolism risk, especially for patients who are considered ineligible for anticoagulation. The most frequently used occluders worldwide include the WATCHAMN (Boston Scientific, Natick, MA, USA) and the Amplatzer Cardiac Plug or Amulet (St. Jude Medical/Abbott, St Paul, MN, USA) devices. Multimodality imaging is key in the understanding of 3D aspects of the LAA and surrounding structures anatomy. Imaging is essential for procedural planning, during each step of the procedure and for device surveillance after implantation. Multimodality imaging, including 2D/3D echocardiography, fluoroscopy, and cardiac computed tomography can increase the safety and efficacy of the procedure.

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Section: Rotational Angiographymentioning

confidence: 99%

Role of Imaging in Left Atrial Appendage Occlusion

Lempereur

Aminian

Potter

et al. 2017

ijcp

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“…Finally, the contrast medium was injected and C-arm rotation initiated with a 2 s delay. Along with the left atrial rotational angiography, all patients underwent a 3D rotational esophagography to visualize the position of the esophagus and its relation to other cardiac structures 20 . Opacification was achieved by swallowing 30-50 mL of barium sulfate esophageal cream (Micropaque -Guerbet, Roissy, France) five seconds before the initiation of rotational run.…”

Section: Three-dimensional Rotation Angiographymentioning

confidence: 99%

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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“…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).…”

Section: Rotational Angiographymentioning

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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Three-dimensional rotational angiography of the left atrium and esophagus—A virtual computed tomography scan in the electrophysiology lab?

Cited by 84 publications

References 19 publications

Role of Imaging in Left Atrial Appendage Occlusion

Role of Imaging in Left Atrial Appendage Occlusion

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

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

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