Document Detail

Intraprocedural reconstruction of the left atrium and pulmonary veins as a single navigation tool for ablation of atrial fibrillation: a feasibility, efficacy, and safety study.
MedLine Citation:
PMID:  19411189     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Pulmonary vein (PV) isolation is a technically challenging intervention. For this reason, integration of three-dimensional imaging with computed tomography (CT) or magnetic resonance imaging (MRI) in order to enhance effectiveness and safety has been widely adopted. A novel imaging approach--intraprocedural rotational angiography and reconstruction of the left atrium and PVs--is feasible and provides high anatomic accuracy. OBJECTIVE: The purpose of this study was to prove the feasibility, safety, and efficacy of this imaging approach as a single navigation tool for PV isolation. METHODS: Forty-four patients (25 men and 19 women; age 57 +/- 11 years) with atrial fibrillation (AF) who presented for PV isolation were studied. Rotational angiography during adenosine-induced ventricular asystole was performed under sedation with propofol. The left atrium and PVs were reconstructed by three-dimensional atriography using specialized software (EP navigator prototype, Philips Medical Systems). Three-dimensional atriography was used as a single navigation tool for guiding PV isolation. RESULTS: Of 176 PVs, 174 (99%) were isolated. Total procedural and fluoroscopy times were 192 +/- 46 minutes and 44 +/- 12 minutes, respectively. During follow-up of 6 +/- 3 months, 31 (70%) patients were free of symptoms and had no evidence of AF without any antiarrhythmic medication. MRI examination of 41 patients at 3-month follow-up excluded PV stenosis. No major complications occurred. CONCLUSION: Three-dimensional atriography is a novel intraprocedural three-dimensional imaging technique that is based on rotational angiography. It can be safely and effectively used as a single navigation tool for performing PV isolation.
Charalampos Kriatselis; Min Tang; Sotirios Nedios; Mattias Roser; Hong Gerds-Li; Eckart Fleck
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Publication Detail:
Type:  Journal Article     Date:  2009-02-25
Journal Detail:
Title:  Heart rhythm : the official journal of the Heart Rhythm Society     Volume:  6     ISSN:  1556-3871     ISO Abbreviation:  Heart Rhythm     Publication Date:  2009 Jun 
Date Detail:
Created Date:  2009-05-26     Completed Date:  2009-10-08     Revised Date:  2009-10-27    
Medline Journal Info:
Nlm Unique ID:  101200317     Medline TA:  Heart Rhythm     Country:  United States    
Other Details:
Languages:  eng     Pagination:  733-41     Citation Subset:  IM    
Department of Internal Medicine/Cardiology, Deutsches Herzzentrum Berlin, Berlin, Germany.
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MeSH Terms
Atrial Fibrillation / surgery*
Catheter Ablation
Feasibility Studies
Heart Atria / radiography,  surgery*
Middle Aged
Pulmonary Veins / radiography,  surgery*
Reconstructive Surgical Procedures
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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