CMR atrial angiography makes redo AF ablations faster and easier with less x-ray fluoroscopy
KeywordsCatheter Ablation Fluoroscopy Time Radiofrequency Catheter Ablation Electroanatomic Mapping Total Procedure Time
To determine if merging CMR atrial angiograms with the fluoroscopy and ECG mapping during the ablation procedure make redo AF ablations easier.
AF ablations have a relatively low success rate (52–74%) and are long, complex procedures. CT merge into electroanatomic mapping in the catheter lab has been shown to produce better outcomes than using electroanatomic mapping alone. However, CT is associated with substantial radiation exposure. It is unclear whether CMR integration offers similar benefits. We hypothesised that CMR-derived 3D atrial anatomical merge would result in faster, easier procedures with less use of ionising radiation.
64 patients (39 male, mean age: 57 +/- 12 years) underwent repeat radiofrequency catheter ablation of atrial fibrillation. Twenty-two (34%, the MERGE group) had a CMR merge, while 42 (66%, NO MERGE) did not. All patients underwent their procedure using the Ensite NavX system (St Jude Medical). The CMR atrial angiogram was performed prior to the procedure (non-gated, 3D atrial angiogram, 0.1 mmol/Kg contrast, timed for atrial delineation), and was available (non-subtracted) for importing into the cardiac catheterisation suite.
CMR integration into electroanatomic mapping results in a reduction in procedure times and x-ray fluoroscopy in redo AF ablation compared to electroanatomic mapping alone. This is a potential benefit over CT image integration and electroanatomic mapping alone.
This article is published under license to BioMed Central Ltd.