Abstract 627: Real-Time Three-Dimensional Image Integration in Atrial Fibrillation Ablation: A Randomised Comparison with an Electroanatomic Mapping System
Pulmonary vein isolation (PVI) has been shown effective for the treatment of atrial fibrillation (Afib). Because PVI can be technically challenging, integration of three-dimensional imaging (3DI) has been widely adopted in order to enhance effectiveness and safety of the PVI procedures. The purpose of this study was to compare a new 3DI system with a widespread electroanatomic mapping (EAM) system in patients undergoing PVI. We included 60 patients (18 females) with Afib presented for PVI. All patients underwent a 64 slice CT-scan one day before the scheduled procedure. The patients were randomized to undergo PVI with either an EAM system combined with CT imaging (CARTO merge, Biosense Webster, USA) or with use of a reconstructed left atrium image derived from the rotational angiography (RTA) data by using a specialized software (Figure⇓, EP Prenavigator, Philips Medical Systems, Best, NL). In the latter group, real-time 3DI of left atrium was achieved from RTA during adenosine-induced asystole (>6 sec). CT imaging data were not available for the operator in this group. Table 1⇓ shows the comparison between RTA-and EAM-based ablation procedures. RTA-based PVI can be successfully performed without preprocedural CT imaging. Compared to EAM-based PVI, it is less time-consuming and can be performed with less fluoroscopy time and radiation dose.