Abstract 5805: Three-Dimensional Left Atrial and Oesophagus Reconstruction Using Cardiac C-Arm Computed Tomography with Image Integration into Fluoroscopic Views for Ablation of Atrial Fibrillation: Accuracy of a Novel Modality in Comparison to Multislice Computed Tomography.
Visualization of left atrium (LA), pulmonary veins (PV) and esophagus is crucial in PV-isolation (PVI). Cardiac C-Arm Computed Tomography (DynaCT Cardiac) has been introduced as a novel intraprocedural imaging modality based upon a rotational angiography. We proved quantitative accuracy of DynaCT Cardiac as compared to multislice computed tomography (MSCT) in imaging of the LA and PV. 34 consecutive patients (22 male, 64±12 years) with indication for PVI were studied. Diameters of the PV, the left atrial appendage (LAA) and the descending aorta were measured and the position of the esophagus was defined using preprocedural MSCT and intraprocedural DynaCT Cardiac. There was a significant correlation between both techniques for diameters of the LAA (r=0.86, p<0.05), PV (r=0.98, p<0.05), and the descending aorta (r=0.98, p<0.05). The overall correlation of vessel diameters was r=0.99. LA-volumes correlation was r=0,86, p<0.05. A significant difference of the esophageal position was found between preprocedural MSCT and intraprocedural DynaCT Cardiac (r=0.53, p<0.05) Fig 1⇓ depicts DynaCT Cardiac (left) and MSCT (right), upper part shows a cross-sectional view demonstrating the way of measurement of the left superior PV. In the lower part adjustments in a coronal plane are displayed. DynaCT Cardiac is highly accurate in displaying crucial structures for PVI in comparison to results of MSCT. Therefore, DynaCT Cardiac can be used as an alternative imaging technique to improve PVI accuracy. Intra-procedural imaging of the esophagus seems to be helpful in defining the exact position of the esophagus during PVI.