Different Image Integration Modalities to Guide AF Ablation: Impact on Procedural and Fluoroscopy Times

Autor:	Elisa Baldo, Biagio Sassone, Lina Marcantoni, Gianfranco Percoco, Claudio Pratola, Roberto Ferrari, Paolo Artale, Tiziano Toselli
Rok vydání:	2011
Předmět:	medicine.medical_specialty medicine.diagnostic_test business.industry medicine.medical_treatment Magnetic resonance imaging Catheter ablation Atrial fibrillation General Medicine medicine.disease Ablation Pulmonary vein medicine Fluoroscopy Radiology Cardiology and Cardiovascular Medicine Lead (electronics) business Nuclear medicine Image integration
Zdroj:	Pacing and Clinical Electrophysiology. 34:422-430
ISSN:	0147-8389
Popis:	Background: Different image integration modalities are available for atrial fibrillation (AF) ablation, but their impact on procedural and fluoroscopy times has not been evaluated yet. Methods: Sixty patients (mean age 52.2 ± 12.0 years, 48.3% men, 75% paroxysmal AF) undergoing pulmonary vein (PV) encircling with PV disconnection for symptomatic drug-refractory AF were randomized to ablation with CARTO electroanatomical mapping (Biosense Webster, Diamond Bar, CA, USA) integrated with: (1) preprocedural magnetic resonance imaging (MRI; Group 1); (2) intracardiac echocardiography (ICE; Group 2); (3) preprocedural MRI and ICE (Group 3). Results: PV disconnection was achieved in all patients. Total procedural time (Group 1: 124.7 ± 47.0; Group 2: 112.5 ± 30.4; Group 3: 108.6 ± 34.7 minutes) and total ablation time were similar between groups (P = ns). MRI integration alone required a higher fluoroscopy time (23.8 ± 6.9 in Group 1 vs 11.0 ± 2.3 and 13.9 ± 4.2 minutes in Groups 2 and 3, respectively; P < 0.005) and a longer time spent in the left atrium (109.0 ± 43.5 in Group 1 vs 78.2 ± 29.7 and 74.8 ± 34.3 minutes in Groups 2 and 3, respectively; P = 0.03) in comparison to ICE integration. Addition of MRI to ICE integration showed a tendency for a higher fluoroscopy time in comparison to ICE integration alone (P = 0.06). At a mean follow-up of 9.1 ± 2.2 months, there were no significant differences in AF recurrences among the groups (P = ns). Conclusion: ICE image integration significantly reduces the fluoroscopy time and the time spent in the left atrium in comparison to MRI integration alone. Addition of MRI to ICE integration does not reduce total procedural time and seems to lead to higher fluoroscopy time in comparison to ICE integration alone. (PACE 2011; 34:422–430)
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_________::8438d73f23f9f9a6c6e9e205efc1e1e6 https://doi.org/10.1111/j.1540-8159.2010.02989.x Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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