Three-dimensional computed tomography overlay for pulmonary vein antrum isolation: Follow-up and clinical outcomes

P.H. van der Voort, J. Stevenhagen, L.R.C. Dekker, R.W.M. Bullens, A. Meijer

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

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.

Original languageEnglish
Pages (from-to)302-6
Number of pages5
JournalNetherlands Heart Journal
Volume20
Issue number7-8
DOIs
Publication statusPublished - Aug 2012
Externally publishedYes

Fingerprint

Dive into the research topics of 'Three-dimensional computed tomography overlay for pulmonary vein antrum isolation: Follow-up and clinical outcomes'. Together they form a unique fingerprint.

Cite this