title: Prospective randomized comparison of rotational angiography with three-dimensional reconstruction and computed tomography merged with electro-anatomical mapping: a two center atrial fibrillation ablation study.
abstract: OBJECTIVE
  To compare the efficacy and accuracy of rotational angiography with three-dimensional reconstruction (3DATG) image merged with electro-anatomical mapping (EAM) vs. CT-EAM.
  
  
  METHODS
  A prospective, randomized, parallel, two-center study conducted in 36 patients (25 men, age 65 ± 10 years) undergoing AF ablation (33 % paroxysmal, 67 % persistent) guided by 3DATG (group 1) vs. CT (group 2) image fusion with EAM. 3DATG was performed on the Philips Allura Xper FD 10 system. Procedural characteristics including time, radiation exposure, outcome, and navigation accuracy were compared between two groups.
  
  
  RESULTS
  There was no significant difference between the groups in total procedure duration or time spent for various procedural steps. Minor differences in procedural characteristics were present between two centers. Segmentation and fusion time for 3DATG or CT-EAM was short and similar between both centers. Accuracy of navigation guided by either method was high and did not depend on left atrial size. Maintenance of sinus rhythm between the two groups was no different up to 24 months of follow-up.
  
  
  CONCLUSIONS
  This study did not find superiority of 3DATG-EAM image merge to guide AF ablation when compared to CT-EAM fusion. Both merging techniques result in similar navigation accuracy.
authors: Holy Cross Hospital, Fort Lauderdale, FL, USA.
authors: Rishi
authors: R
authors: Anand
authors: Steward St. Elizabeth's Medical Center, 736 Cambridge Street, Boston, MA, 02135, USA.|, Medical Center #23, Moscow, Russian Federation.
authors: Maxim V
authors: MV
authors: Gorev
authors: Steward St. Elizabeth's Medical Center, 736 Cambridge Street, Boston, MA, 02135, USA.|Malatia Medical Center, Yerevan, Armenia.
authors: Hermine
authors: H
authors: Poghosyan
authors: Steward St. Elizabeth's Medical Center, 736 Cambridge Street, Boston, MA, 02135, USA.
authors: Lindsay
authors: L
authors: Pothier
authors: St Jude Medical, Minneapolis, MN, USA.
authors: John
authors: J
authors: Matkins
authors: Brigham and Women's Hospital, Boston, MA, USA.
authors: Gregory
authors: G
authors: Kotler
authors: Steward St. Elizabeth's Medical Center, 736 Cambridge Street, Boston, MA, 02135, USA.
authors: Sarah
authors: S
authors: Moroz
authors: Steward St. Elizabeth's Medical Center, 736 Cambridge Street, Boston, MA, 02135, USA.
authors: James
authors: J
authors: Armstrong
authors: Steward St. Elizabeth's Medical Center, 736 Cambridge Street, Boston, MA, 02135, USA.
authors: Sergei V
authors: SV
authors: Nemtsov
authors: Steward St. Elizabeth's Medical Center, 736 Cambridge Street, Boston, MA, 02135, USA. mvoepdoc@gmail.com.
authors: Michael V
authors: MV
authors: Orlov
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery*; D018780:Body Surface Potential Mapping / Q000706:statistics & numerical data*; D017115:Catheter Ablation / Q000379:methods / Q000401:mortality*; D017023:Coronary Angiography / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000706:statistics & numerical data; D061646:Operative Time; D015995:Prevalence; D011446:Prospective Studies; D015203:Reproducibility of Results; D012307:Risk Factors; D012399:Rotation; D012680:Sensitivity and Specificity; D025321:Surgery, Computer-Assisted / Q000706:statistics & numerical data; D015996:Survival Rate; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*; D016896:Treatment Outcome
keywords: Atrial fibrillation; Catheter ablation; Electro-anatomical mapping; Left atrium; Merge technique; Three-dimensional rotational angiography