Abstract 5661: Three-Dimensional Reconstructions of Left Atrium and Pulmonary Veins based on Intraprocedural C-Arm Rotational Angiography in Comparison to Electroanatomical Mapping: Integration of a Novel Modality into Atrial Fibrillation Ablation

Abstract

Preprocedural imaging and its integration into electroanatomical mapping (EAM) is commonly used in atrial fibrillation (AF) ablation. However, intraprocedural imaging based on rotational angiography (DynaCT Cardiac) may be superior in terms of actuality and may lead to an improved work-flow. Feasibility of integrating Dyna CT Cardiac into EAM has not yet been shown. In 23 patients (62±7 years, 16 male) undergoing catheter ablation of paroxysmal (n=10) or persistent (n=13) AF, we intraprocedurally performed rotational angiography enhanced by contrast agent applied to the pulmonary artery with offline segmentation of left atrium (LA) and pulmonary veins (PV). Fig 1 depicts reconstructed LA and PV-anatomy directly importet into CARTOMerge. Distances between the 2 modalities were analyzed. Direct image integration of prereconstructed 3D-anatomy was feasible in all patients. Procedure time was 156 ± 24 minutes including 11 ± 3 minutes for DynaCT Cardiac registration and segmentation. 132 ± 74 mapping points were taken. Mapping points deviated to intraprocedural DynaCT Cardiac 3D-reconstructions by 2.2 ± 0.4 mm (2.3 ± 0.5 mm in patients suffering from paroxysmal atrial fibrillation (AF) vs. 2.1 ± 0.40 mm persistent AF, n.s.). No complications occured. Integration of intraprocedural Dyna CT Cardiac into EAM was feasible and fast. The work-flow seemed to be improved by avoiding additional preprocedural imaging. The novel modality is highly accurate in comparison to EAM.