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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

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Abstract

Purpose

To compare the efficacy and accuracy of rotational angiography with three-dimensional reconstruction (3DATG) image merged with electro-anatomical mapping (EAM) vs. CT-EAM.

Methods

A prospective, randomized, parallel, two-center study conducted in 36 patients (25 men, age 65 ± 10 years) undergoing AF ablation (33 % paroxysmal, 67 % persistent) guided by 3DATG (group 1) vs. CT (group 2) image fusion with EAM. 3DATG was performed on the Philips Allura Xper FD 10 system. Procedural characteristics including time, radiation exposure, outcome, and navigation accuracy were compared between two groups.

Results

There was no significant difference between the groups in total procedure duration or time spent for various procedural steps. Minor differences in procedural characteristics were present between two centers. Segmentation and fusion time for 3DATG or CT-EAM was short and similar between both centers. Accuracy of navigation guided by either method was high and did not depend on left atrial size. Maintenance of sinus rhythm between the two groups was no different up to 24 months of follow-up.

Conclusion

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.

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Abbreviations

3D:

Three-dimensional

3DATG:

Rotational angiography with 3D reconstruction

AF:

Atrial Fibrillation

CT:

Computed Tomography

EAM:

Electro-anatomical mapping

EGM:

Electrogram

LA:

Left atrium/left atrial

PV:

Pulmonary vein

CS:

Coronary sinus

PVI:

Pulmonary Vein Isolation

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Authors and Affiliations

  1. Holy Cross Hospital, Fort Lauderdale, FL, USA

    Rishi Anand

  2. Steward St. Elizabeth’s Medical Center, 736 Cambridge Street, Boston, MA, 02135, USA

    Maxim V. Gorev, Hermine Poghosyan, Lindsay Pothier, Sarah Moroz, James Armstrong, Sergei V. Nemtsov & Michael V. Orlov

  3. Medical Center #23, Moscow, Russian Federation

    Maxim V. Gorev

  4. Malatia Medical Center, Yerevan, Armenia

    Hermine Poghosyan

  5. St Jude Medical, Minneapolis, MN, USA

    John Matkins

  6. Brigham and Women’s Hospital, Boston, MA, USA

    Gregory Kotler

Authors
  1. Rishi Anand
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  2. Maxim V. Gorev
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  3. Hermine Poghosyan
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  4. Lindsay Pothier
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  5. John Matkins
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  6. Gregory Kotler
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  7. Sarah Moroz
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  8. James Armstrong
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  9. Sergei V. Nemtsov
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  10. Michael V. Orlov
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Corresponding author

Correspondence to Michael V. Orlov.

Ethics declarations

This study was approved by the Institutional Review Board at each center and registered at www.clinicaltrials.gov (NCT ID #01537237). Informed consent was obtained from all individual participants included in the study.

Conflict of interest

John Matkins, RTR is an employee of St. Jude Medical; Dr. Michael Orlov is on the Medical Advisory Board for Philips Healthcare.

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Anand, R., Gorev, M.V., Poghosyan, H. et al. 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. J Interv Card Electrophysiol 46, 71–79 (2016). https://doi.org/10.1007/s10840-016-0111-z

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  • DOI: https://doi.org/10.1007/s10840-016-0111-z

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