Volume 34, Issue 3 pp. 315-322

Intraprocedural Imaging of Left Atrium and Pulmonary Veins: A Comparison Study between Rotational Angiography and Cardiac Computed Tomography

CHARALAMPOS KRIATSELIS M.D.,

CHARALAMPOS KRIATSELIS M.D.

Department of Internal Medicine/Cardiology, Deutsches Herzzentrum Berlin, Berlin, Germany

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SOTIRIOS NEDIOS M.D.,

SOTIRIOS NEDIOS M.D.

Department of Internal Medicine/Cardiology, Deutsches Herzzentrum Berlin, Berlin, Germany

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SPYRIDON AKRIVAKIS M.D.,

SPYRIDON AKRIVAKIS M.D.

Caritas St. Elizabeth's Medical Center of Boston, Tufts University Medical School, Boston, Massachusetts

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MIN TANG M.D.,

MIN TANG M.D.

Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China

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MATTIAS ROSER M.D.,

MATTIAS ROSER M.D.

Department of Internal Medicine/Cardiology, Deutsches Herzzentrum Berlin, Berlin, Germany

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JIN-HONG GERDS-LI M.D.,

JIN-HONG GERDS-LI M.D.

Department of Internal Medicine/Cardiology, Deutsches Herzzentrum Berlin, Berlin, Germany

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ECKART FLECK M.D.,

ECKART FLECK M.D.

Department of Internal Medicine/Cardiology, Deutsches Herzzentrum Berlin, Berlin, Germany

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MICHAEL ORLOV M.D.,

MICHAEL ORLOV M.D.

Caritas St. Elizabeth's Medical Center of Boston, Tufts University Medical School, Boston, Massachusetts

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CHARALAMPOS KRIATSELIS M.D.,

CHARALAMPOS KRIATSELIS M.D.

Department of Internal Medicine/Cardiology, Deutsches Herzzentrum Berlin, Berlin, Germany

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SOTIRIOS NEDIOS M.D.,

SOTIRIOS NEDIOS M.D.

Department of Internal Medicine/Cardiology, Deutsches Herzzentrum Berlin, Berlin, Germany

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SPYRIDON AKRIVAKIS M.D.,

SPYRIDON AKRIVAKIS M.D.

Caritas St. Elizabeth's Medical Center of Boston, Tufts University Medical School, Boston, Massachusetts

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MIN TANG M.D.,

MIN TANG M.D.

Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China

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MATTIAS ROSER M.D.,

MATTIAS ROSER M.D.

Department of Internal Medicine/Cardiology, Deutsches Herzzentrum Berlin, Berlin, Germany

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JIN-HONG GERDS-LI M.D.,

JIN-HONG GERDS-LI M.D.

Department of Internal Medicine/Cardiology, Deutsches Herzzentrum Berlin, Berlin, Germany

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ECKART FLECK M.D.,

ECKART FLECK M.D.

Department of Internal Medicine/Cardiology, Deutsches Herzzentrum Berlin, Berlin, Germany

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MICHAEL ORLOV M.D.,

MICHAEL ORLOV M.D.

Caritas St. Elizabeth's Medical Center of Boston, Tufts University Medical School, Boston, Massachusetts

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First published: 18 November 2010

https://doi.org/10.1111/j.1540-8159.2010.02969.x

Citations: 20

Address for reprints: Charalampos Kriatselis, M.D., Department of Internal Medicine/Cardiology, German Heart Institute Berlin, Augustenburger Platz 1, 13353 Berlin, Germany. Fax: 0049-30-4593 2438; e-mail: [email protected]

Funding: S. Nedios receives a research scholarship from the Greek State Scholarship Foundation (IKY).

Dr. Ch. Kriatselis and Dr. S. Nedios contributed equally to this work.

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Abstract

Background: Atrial fibrillation (AF) ablation is facilitated by anatomical visualization of the left atrium (LA) and the pulmonary veins (PVs). The purpose of this study was to compare accuracy, radiation exposure, and costs between three-dimensional atriography (3D-ATG) and cardiac computed tomography (CCT).

Methods: Seventy patients with an indication for AF ablation were included. Contrast-enhanced CCT was performed preoperatively for all patients. In addition, intraoperative 3D-ATG was performed with contrast medium injection either indirectly into the pulmonary arteries during a breath-hold (Ind.-RTA, n = 25) or directly into the LA, during adenosine-induced asystole (Ad.-RTA, n = 23), or rapid ventricular pacing (VP-RTA, n = 22). We evaluated vertical ostial PV diameters and LA volume, time needed to perform, radiation exposure, and procedural cost for each imaging method.

Results: The correlation coefficient between 3D-ATG and CCT for the ostial PV diameters was r = 0.83 for Ind.-RTA, 0.91 for Ad.-RTA, and 0.88 for the VP-RTA method (P > 0.05). The volume correlations were r = 0.87 for Ind.-RTA, 0.82 for Ad.-RTA, and 0.8 for VP-RTA (P > 0.05). Time to perform was 13 ± 5 minutes for ATG and 46 ± 9 minutes for CCT (P < 0.05). Effective radiation dose was 2.2 ± 0.2 mSv for ATG and 20.4 ± 7.4 mSv for CCT (P < 0.05). The procedural cost was estimated at 91–95 € for ATG and at 126–151 € for CCT.

Conclusions: 3D-ATG is an intraprocedural imaging modality that provides anatomical accuracy comparable to that of CCT with significantly lower radiation dose, in less time and at less financial expense (PACE 2011; 34:315–322)

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Volume34, Issue3

March 2011

Pages 315-322

Intraprocedural Imaging of Left Atrium and Pulmonary Veins: A Comparison Study between Rotational Angiography and Cardiac Computed Tomography

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Intraprocedural Imaging of Left Atrium and Pulmonary Veins: A Comparison Study between Rotational Angiography and Cardiac Computed Tomography

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