title: Impact of preprocedural imaging on outcomes of catheter ablation in patients with atrial fibrillation.
abstract: OBJECTIVE
  This study aims to determine the impact of preprocedural imaging using computerized tomography (CT) or magnetic resonance imaging (MRI) with 3-D reconstruction on procedural efficiency, efficacy, complications and clinical outcome in patients who undergo radiofrequency catheter ablation (RFA) to eliminate atrial fibrillation (AF).
  
  
  METHODS
  In this registry, a CT (n = 161) or MRI (n = 37) was obtained prior to RFA in 198 of 333 consecutive patients (age 61 ± 10 years) with paroxysmal (172) or persistent (161) AF. Antral pulmonary vein isolation was performed in all patients using an open-irrigation-tip catheter with a 3-D electroanatomical navigation system. Procedural and clinical outcomes were compared among patients who underwent RFA with and without preprocedural imaging.
  
  
  RESULTS
  The mean duration of the procedure (246 ± 47 vs. 242 ± 40 min, P = 0.55), fluoroscopy (47 ± 13 vs. 50 ± 10 min, P = 0.16), and total RF application (83 ± 27 vs. 78 ± 23 min, P = 0.17) were similar among patients who did and did not have preprocedural imaging. The likelihood of a complication also was similar (5/198 [3%] vs. 4/135 [3%], P = 1.0). A repeat ablation was performed in 95/198 (48%) and 61/135 (45%) of the patients who did and did not have imaging study, respectively (P = 0.62). At 22 ± 9 months, after a mean of 2 ± 1 procedures, 140/198 (71%) and 101/135 (75%) of the patients who did and did not have preprocedural imaging were in sinus rhythm (P = 0.4).
  
  
  CONCLUSIONS
  Preprocedural awareness of pulmonary venous and left atrial anatomy does not appear to have an effect on procedural efficiency or clinical outcomes in patients who undergo catheter ablation for AF.
authors.affiliation: Division of Cardiovascular Medicine, Cardiovascular Center, SPC 5853, University of Michigan, 1500 East Medical Center Drive, Ann Arbor, MI 48109-5853, USA.
authors.forename: Miki
authors.initials: M
authors.lastname: Yokokawa
authors.forename: Hilal
authors.initials: H
authors.lastname: Olgun
authors.forename: Baskaran
authors.initials: B
authors.lastname: Sundaram
authors.forename: Aman
authors.initials: A
authors.lastname: Chugh
authors.forename: Rakesh
authors.initials: R
authors.lastname: Latchamsetty
authors.forename: Eric
authors.initials: E
authors.lastname: Good
authors.forename: Thomas
authors.initials: T
authors.lastname: Crawford
authors.forename: Krit
authors.initials: K
authors.lastname: Jongnarangsin
authors.forename: Frank
authors.initials: F
authors.lastname: Pelosi
authors.forename: Frank
authors.initials: F
authors.lastname: Bogun
authors.forename: Fred
authors.initials: F
authors.lastname: Morady
authors.forename: Hakan
authors.initials: H
authors.lastname: Oral
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D011667:Pulmonary Veins / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D012042:Registries; D025321:Surgery, Computer-Assisted / Q000295:instrumentation*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome