Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Apr;60(3):477-484.
doi: 10.1007/s10840-020-00764-4. Epub 2020 May 13.

Role of pre-procedural CT imaging on catheter ablation in patients with atrial fibrillation: procedural outcomes and radiological exposure

Andrea Di Cori  1 , Giulio Zucchelli  2 , Lorenzo Faggioni  3 , Luca Segreti  2 , Raffaele De Lucia  2 , Valentina Barletta  2 , Stefano Viani  2 , Luca Paperini  2 , Matteo Parollo  2 , Ezio Soldati  2 , Davide Caramella  3 , Maria Grazia Bongiorni  2
Affiliations

Role of pre-procedural CT imaging on catheter ablation in patients with atrial fibrillation: procedural outcomes and radiological exposure

Andrea Di Cori et al. J Interv Card Electrophysiol. 2021 Apr.

Abstract

Background: Cardiac computed tomography (CT) is commonly used to study left atrial (LA) and pulmonary veins (PVs) anatomy before atrial fibrillation (AF) ablation. The aim of the study was to determine the impact of pre-procedural cardiac CT with 3D reconstruction on procedural outcomes and radiological exposure in patients who underwent radiofrequency catheter ablation (RFA) of AF.

Methods: In this registry, 493 consecutive patients (age 62 ± 8 years, 70% male) with paroxysmal (316) or persistent (177) AF who underwent first procedure of RFA were included. A pre-procedural CT scan was obtained in 324 patients (CT group). Antral pulmonary vein isolation was performed in all patients using an open-irrigation-tip catheter with a 3D electroanatomical navigation system. Procedural outcome, including radiological exposure, and clinical outcomes were compared among patients who underwent RFA with (CT group) and without (no CT group) pre-procedural cardiac CT.

Results: Acute PV isolation was obtained in all patients, with a comparable overall complication rate between CT and no CT group (4.3% vs 3%, p = 0.7). No differences were observed about mean duration of the procedure (231 ± 60 vs 233 ± 58 min, p = 0.7) and fluoroscopy time (13 ± 10 vs 13 ± 8 min, p = 0.6) among groups. Cumulative radiation dose resulted significantly higher in the CT group compared with no CT group (8.9 ± 24 vs 4.8 ± 15 mSv, P = 0.02). At 1 year, freedom from AF/atrial tachycardia were comparable among groups (CT group, 227/324 (70%), vs no CT group,119/169 (70%), p = ns).

Conclusions: Pre-procedural CT does not improve safety and efficacy of AF ablation, increasing significantly the cumulative radiological exposure.

Keywords: Ablation; Atrial fibrillation; Cardiac computed tomography; Radiological dose.

PubMed Disclaimer

References

    1. Kistler PM, Earley MJ, Harris S, Abrams D, Ellis S, Sporton SC, et al. Validation of three-dimensional cardiac image integration: use of integrated CT image into electroanatomic mapping system to perform catheter ablation of atrial fibrillation. J Cardiovasc Electrophysiol. 2006;17(4):341–8. - DOI
    1. Ho SY, Sanchez-Quintana D, Cabrera JA, Anderson RH. Anatomy of the left atrium: implications for radiofrequency ablation of atrial fibrillation. J Cardiovasc Electrophysiol. 1999;10(11):1525–33. - DOI
    1. Heist EK, Holmvang G, Abbara S, Ruskin JN, Mansour M. Pre-Procedural Imaging to Direct Catheter Ablation of Atrial Fibrillation: Anatomy and Ablation Strategy. J Atr Fibrillation. 2008;1(2):13.4.
    1. Yokokawa M, Olgun H, Sundaram B, Chugh A, Latchamsetty R, Good E, et al. Impact of preprocedural imaging on outcomes of catheter ablation in patients with atrial fibrillation. J Interv Card Electrophysiol. 2012;34(3):255–62. - DOI
    1. Chyou JY, Biviano A, Magno P, Garan H, Einstein AJ. Applications of computed tomography and magnetic resonance imaging in percutaneous ablation therapy for atrial fibrillation. J Interv Card Electrophysiol. 2009;26:47–57. - DOI

LinkOut - more resources