Rapid ventricular pacing to optimize rotational angiography in atrial fibrillation ablation.
BACKGROUND
Conventional pulmonary vein (PV) angiography cannot precisely delineate the left atrium (LA)-PV anatomy, which is essential for the ablation of atrial fibrillation (AF). The aim of the study was to test the feasibility of a novel method of rotational angiography for the AF ablation.


RESULTS
Forty-one patients were enrolled in this study. CT scanning was performed in all patients before the procedure. Rotational angiography (rotating from right anterior oblique 55 degrees to left anterior oblique 55 degrees ) was performed before AF ablation. Rapid ventricular pacing (RVP, 300 ms) was carried out to reduce cardiac output while contrast medium was injected into the LA via a pigtail catheter. RVP was successfully performed in 36 (87.8%) patients. The ostia of all PVs and the LA appendage were visible in all these 36 cases. There was a good correlation in the PV ostial diameters as assessed by rotational angiography via RVP as compared to CT imaging (r (2) > 0.85).


CONCLUSIONS
Rotational angiography by RVP is able to delineate the LA-PV anatomy. There is a good correlation in the PV ostial diameters as assessed by rotational angiography via RVP and CT imaging. Rotational angiography by RVP is feasible during AF ablation.
Gerds-Li
Jin-Hong
JH
Department of Internal Medicine/Cardiology, German Heart Institute, 13353, Berlin, Germany. gerds-li@dhzb.de
Tang
Min
M
Kriatselis
Charalampos
C
Roser
Mathias
M
Goetze
Stephan
S
He
Dingsheng
D
Fleck
Eckard
E
D000792:Angiography / Q000379:methods*; D001281:Atrial Fibrillation / Q000000981:diagnostic imaging* / Q000601:surgery*; D002304:Cardiac Pacing, Artificial / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010690:Phlebography / Q000379:methods; D011667:Pulmonary Veins / Q000000981:diagnostic imaging* / Q000601:surgery*; D011856:Radiographic Image Enhancement / Q000379:methods; D015641:Radiography, Interventional / Q000379:methods; D012399:Rotation; D012680:Sensitivity and Specificity; D025321:Surgery, Computer-Assisted / Q000379:methods*; D016896:Treatment Outcome