title: Image integration increases efficacy of paroxysmal atrial fibrillation catheter ablation: results from the CartoMerge Italian Registry.
abstract: OBJECTIVE
  The aim of this study was to investigate whether circumferential pulmonary vein (PV) isolation guided by image integration improves the procedural and clinical outcomes of atrial fibrillation (AF) ablation in comparison with segmental PV isolation and circumferential PV isolation guided by three-dimensional (3D) electroanatomical mapping alone.
  
  
  RESULTS
  Procedural and clinical outcomes of 573 patients who underwent their first catheter ablation for paroxysmal AF between January 2005 and April 2007 were collected from 12 centres. We evaluated three techniques: segmental ostial PV isolation (SOCA group, 240 patients), circumferential PV isolation guided by electroanatomical mapping (CARTO group, 107 patients), and circumferential PV isolation guided by electroanatomical mapping integrated with magnetic resonance/computed tomographic images of the left atrium (MERGE group, 226 patients). Procedure duration proved to be shorter in MERGE group patients than in CARTO group patients (P < 0.04), but longer than in SOCA group patients (P < 0.0001). During follow-up, atrial tachyarrhythmias relapsed more frequently in SOCA group patients (44.6%) and CARTO group patients (41.7%) than in MERGE group patients (22.6%; P < 0.0001).
  
  
  CONCLUSIONS
  In patients with paroxysmal AF, circumferential PV isolation guided by image integration significantly improves clinical outcome in comparison with both circumferential PV isolation guided by 3D mapping alone and with segmental electrophysiologically guided PV isolation.
authors.affiliation: Ospedale Civile di Mirano, Via Mariutto, 13-30035 Mirano, Italy. bertagliaferro@alice.it
authors.forename: Emanuele
authors.initials: E
authors.lastname: Bertaglia
authors.forename: Paolo Della
authors.initials: PD
authors.lastname: Bella
authors.forename: Claudio
authors.initials: C
authors.lastname: Tondo
authors.forename: Alessandro
authors.initials: A
authors.lastname: Proclemer
authors.forename: Nicola
authors.initials: N
authors.lastname: Bottoni
authors.forename: Roberto
authors.initials: R
authors.lastname: De Ponti
authors.forename: Maurizio
authors.initials: M
authors.lastname: Landolina
authors.forename: Maria Grazia
authors.initials: MG
authors.lastname: Bongiorni
authors.forename: Leonardo
authors.initials: L
authors.lastname: Corò
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Stabile
authors.forename: Antonio
authors.initials: A
authors.lastname: Dello Russo
authors.forename: Roberto
authors.initials: R
authors.lastname: Verlato
authors.forename: Massimo
authors.initials: M
authors.lastname: Mantica
authors.forename: Franco
authors.initials: F
authors.lastname: Zoppo
mesh_terms: D001281:Atrial Fibrillation / Q000401:mortality*; D018780:Body Surface Potential Mapping / Q000706:statistics & numerical data*; D017115:Catheter Ablation / Q000401:mortality*; D003952:Diagnostic Imaging / Q000706:statistics & numerical data*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008875:Middle Aged; D011379:Prognosis; D013382:Subtraction Technique / Q000706:statistics & numerical data; D025321:Surgery, Computer-Assisted / Q000706:statistics & numerical data*; D016019:Survival Analysis; D015996:Survival Rate; D016896:Treatment Outcome; D015018:Ytterbium
chemical_list: D015018:Ytterbium