title: Determination of left atrium volume by fast anatomical mapping and intracardiac echocardiography. The contribution of respiratory gating.
abstract: BACKGROUND
  The anatomical reconstruction of the left atrium (LA) and pulmonary veins with fast anatomical mapping (FAM) and intracardiac echocardiography (ICE) using the Carto 3 system (Biosense Webster, Inc) provides real-time guidance to catheter manipulation during ablation of atrial fibrillation (AF). The present study compared real-time LA volume reconstruction using FAM and ICE. In addition, the contribution of respiratory gating was assessed.
  
  
  METHODS
  LA reconstruction was created using FAM and ICE in 60 consecutive patients (mean age 63 ± 9 years; 38 males) undergoing AF ablation. In the first 30 patients, FAM and ICE were performed without respiratory gating. In the last 30 patients, FAM and ICE were performed with respiratory gating.
  
  
  RESULTS
  LA volumes determined by FAM were larger than those obtained with ICE in the absence of respiratory gating (n = 30; 129.5 ± 44 vs 110 ± 39.7 cm(3); p = 0.001). However, respiratory gating reduced LA volume determined with FAM by 17.7 ± 6.6% resulting in similar LA volumes to those obtained using ICE [n = 30; 100 ± 29.7 (61-154) vs 101.53 ± 40.1 (56-212) cm(3), p = 0.7, NS].
  
  
  CONCLUSIONS
  In the absence of respiratory gating, LA volumes determined by FAM are larger than those obtained with ICE. In contrast, with the addition of respiratory gating, both FAM and ICE provide similar real-time LA volumes.
authors.affiliation: Penn State Heart & Vascular Institute, Milton S. Hershey Medical Center, Penn State University, 500 University Dr. H047, Hershey, PA, 17033, USA.
authors.forename: Faris
authors.initials: F
authors.lastname: Khan
authors.forename: Javier E
authors.initials: JE
authors.lastname: Banchs
authors.forename: Joshua B
authors.initials: JB
authors.lastname: Skibba
authors.forename: Jennifer
authors.initials: J
authors.lastname: Grando-Ting
authors.forename: John
authors.initials: J
authors.lastname: Kelleman
authors.forename: Harjit
authors.initials: H
authors.lastname: Singh
authors.forename: Mario D
authors.initials: MD
authors.lastname: Gonzalez
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000601:surgery*; D018780:Body Surface Potential Mapping / Q000379:methods*; D017115:Catheter Ablation / Q000379:methods*; D015331:Cohort Studies; D019560:Echocardiography, Three-Dimensional / Q000379:methods*; D005500:Follow-Up Studies; D006325:Heart Atria; D006801:Humans; D018810:Magnetic Resonance Angiography / Q000379:methods; D008875:Middle Aged; D009929:Organ Size; D012123:Pulmonary Ventilation / Q000502:physiology; D018570:Risk Assessment; D012494:Sampling Studies; D025321:Surgery, Computer-Assisted / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome