Reduction of Radiation Exposure in Atrial Fibrillation Ablation Using a New Image Integration Module: A Prospective Randomized Trial in Patients Undergoing Pulmonary Vein Isolation
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Reduction of Radiation Exposure in Atrial Fibrillation Ablation Using a New Image Integration Module: A Prospective Randomized Trial in Patients Undergoing Pulmonary Vein Isolation. / Akbulak, Ruken Özge; Schäffer, Benjamin; Jularic, Mario; Moser, Julia; Schreiber, Doreen; Salzbrunn, Tim; Meyer, Christian; Eickholt, Christian; Kuklik, Pawel; Hoffmann, Boris A; Willems, Stephan.
In: J CARDIOVASC ELECTR, Vol. 26, No. 7, 07.2015, p. 747-753.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Reduction of Radiation Exposure in Atrial Fibrillation Ablation Using a New Image Integration Module: A Prospective Randomized Trial in Patients Undergoing Pulmonary Vein Isolation
AU - Akbulak, Ruken Özge
AU - Schäffer, Benjamin
AU - Jularic, Mario
AU - Moser, Julia
AU - Schreiber, Doreen
AU - Salzbrunn, Tim
AU - Meyer, Christian
AU - Eickholt, Christian
AU - Kuklik, Pawel
AU - Hoffmann, Boris A
AU - Willems, Stephan
N1 - © 2015 Wiley Periodicals, Inc.
PY - 2015/7
Y1 - 2015/7
N2 - INTRODUCTION: Recently, a new image integration module (IIM, CartoUnivu™ Module) has been introduced to combine and merge fluoroscopy images with 3-dimensional-(3D)-electroanatomical maps (Carto® 3 System) into an accurate 3D view. The aim of the study was to investigate the influence of IIM on the fluoroscopy exposure during pulmonary vein isolation (PVI) for paroxysmal atrial fibrillation (PAF) in a prospective randomized trial.METHODS AND RESULTS: Between June and November 2014, a total of 60 patients with PAF (73.3% male, 64.0 ± 9.2 years), who underwent PVI with the endpoint of unexcitability of the ablation line, were randomized to either a conventional 3D mapping system (Carto® 3 System) or to an additional IIM on the basis of an assumed reduction of fluoroscopy exposure by the use of IIM. There were no significant differences in baseline characteristics. The median ablation procedure time was identical in both groups (140.7 ± 27.8 minutes vs. 140.8 ± 39.5 minutes; P = 0.851). A significant decrease of mean fluoroscopy time from 11.9 ± 2.1 to 7.4 ± 2.6 minutes (P < 0.0006) and median fluoroscopy dose from 882.9 to 476.5 cGycm(2) (P < 0.001) was achieved. The main reduction of radiation could be realized during creation of the 3D-map. No major complications occurred during the procedures. After a median follow-up of 125.7 ± 45.6 days 80% of the patients were free from any atrial arrhythmias.CONCLUSION: CartoUnivu™ module easily integrates into the workflow of PVI with the endpoint of unexcitability of the ablation line without prolonging the procedure time. It is associated with a marked reduction in fluoroscopic dose when compared to a conventional 3D mapping system.
AB - INTRODUCTION: Recently, a new image integration module (IIM, CartoUnivu™ Module) has been introduced to combine and merge fluoroscopy images with 3-dimensional-(3D)-electroanatomical maps (Carto® 3 System) into an accurate 3D view. The aim of the study was to investigate the influence of IIM on the fluoroscopy exposure during pulmonary vein isolation (PVI) for paroxysmal atrial fibrillation (PAF) in a prospective randomized trial.METHODS AND RESULTS: Between June and November 2014, a total of 60 patients with PAF (73.3% male, 64.0 ± 9.2 years), who underwent PVI with the endpoint of unexcitability of the ablation line, were randomized to either a conventional 3D mapping system (Carto® 3 System) or to an additional IIM on the basis of an assumed reduction of fluoroscopy exposure by the use of IIM. There were no significant differences in baseline characteristics. The median ablation procedure time was identical in both groups (140.7 ± 27.8 minutes vs. 140.8 ± 39.5 minutes; P = 0.851). A significant decrease of mean fluoroscopy time from 11.9 ± 2.1 to 7.4 ± 2.6 minutes (P < 0.0006) and median fluoroscopy dose from 882.9 to 476.5 cGycm(2) (P < 0.001) was achieved. The main reduction of radiation could be realized during creation of the 3D-map. No major complications occurred during the procedures. After a median follow-up of 125.7 ± 45.6 days 80% of the patients were free from any atrial arrhythmias.CONCLUSION: CartoUnivu™ module easily integrates into the workflow of PVI with the endpoint of unexcitability of the ablation line without prolonging the procedure time. It is associated with a marked reduction in fluoroscopic dose when compared to a conventional 3D mapping system.
KW - Action Potentials
KW - Aged
KW - Atrial Fibrillation/diagnosis
KW - Catheter Ablation/methods
KW - Electrophysiologic Techniques, Cardiac/methods
KW - Feasibility Studies
KW - Female
KW - Fluoroscopy
KW - Germany
KW - Heart Conduction System/diagnostic imaging
KW - Humans
KW - Male
KW - Middle Aged
KW - Operative Time
KW - Predictive Value of Tests
KW - Prospective Studies
KW - Pulmonary Veins/diagnostic imaging
KW - Radiation Dosage
KW - Radiographic Image Interpretation, Computer-Assisted/methods
KW - Radiography, Interventional/methods
KW - Time Factors
KW - Treatment Outcome
KW - Workflow
U2 - 10.1111/jce.12673
DO - 10.1111/jce.12673
M3 - SCORING: Journal article
C2 - 25807878
VL - 26
SP - 747
EP - 753
JO - J CARDIOVASC ELECTR
JF - J CARDIOVASC ELECTR
SN - 1045-3873
IS - 7
ER -
