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Three-dimensional computed tomography overlay for pulmonary vein antrum isolation: Follow-up and clinical outcomes.
MedLine Citation:
PMID:  22653815     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: To facilitate the creation of circumferential lines in pulmonary vein (PV) antrum isolation, three-dimensional (3D) navigation systems are used widely. Alternatively, 3D reconstructions of the left atrium (LA) can be superimposed directly on fluoroscopy to guide ablation catheters and to mark ablation sites. METHODS: In 71 atrial fibrillation patients circumferential PV ablation was performed. 3D reconstructions of the LA were derived from contrast cardiac-computed tomography and circumferential PV isolation was performed. In subsequent ablation procedures, veins were re-isolated, and defragmentation or linear lesions were performed if necessary. RESULTS: Adequate 3D reconstructions were formed and registered to fluoroscopy in all patients. All veins, except 2 in one single patient, could be isolated, resulting in freedom of AF in 45 patients (63 %). In 19 patients a second procedure was performed, in which 2.7 ± 1.1 PV per patient were re-isolated; in 3 patients a third procedure was performed. After follow-up of 15 ± 8 months, 51 (91 %) of patients with paroxysmal and 10 (67 %) with persistent AF were free of AF. CONCLUSIONS: The results of 3D overlay for circumferential PV isolation are good, although the reconduction rate and need for subsequent ablations remains high, and the outcomes of this technique appear to be equivalent to other mapping techniques.
Authors:
P H van der Voort; J Stevenhagen; L R C Dekker; R Bullens; A Meijer
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-6-1
Journal Detail:
Title:  Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation     Volume:  -     ISSN:  1876-6250     ISO Abbreviation:  -     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-6-1     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101095458     Medline TA:  Neth Heart J     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Cardiology, Catharina Hospital, PO Box 1350, 5602, ZA, Eindhoven, the Netherlands, pepijn.vd.voort@catharina-ziekenhuis.nl.
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