Cor Vasa 2011, 53(11):637-643 | DOI: 10.33678/cor.2011.159

The newest radiologic imaging methods used during catheterization ablation of complex atrial arrhythmias

Zdeněk Stárek^*, František Lehar, Jiří Jež, Jiří Wolf, Pavel Leinveber

I. interní kardioangiologická klinika, ICRC, FN u sv. Anny, Lékařská fakulta Masarykovy univerzity, Brno, Česká republika

Aim: To define the optimal protocol for three-dimensional (3D) modeling of heart cavities and adjacent structures using 3D rotational angiography (3DRA).

Methods: One hundred twenty-eight patients underwent 3DRA using two different right atrial protocols (P1 and P2), one left atrial protocol and a right-sided protocol with a manual start (P3). The effectiveness of useful 3D heart cavity model attainment, mostly concerning the left atrium, was evaluated. The analysis of factors influencing the effectiveness of 3DRA (BMI, HR, type of rhythm during application of the contrast medium) was also performed. In 35 patients, we evaluated the effectiveness of esophagus imaging using oral application of the contrast medium.

Results: The protocol P2 (87.5% effectiveness) seemed to be more effective than the protocol P1 (52.94% effectiveness). The effectiveness of the protocol P3 with a manual start (85%) was not different from that of the protocol P2. The highest effectiveness (97.67%) was demonstrated in the left-sided protocol. The esophagus imaging effectiveness was 94%.

Conclusion: 3D rotational angiography of the heart is a reliable method for 3D modeling of heart cavities, especially the left ventricle. The left-sided approach is a robust method with almost 100% effectiveness. As for the right-sided approach, the protocol 2 with a fixed 9 sec delay seemed to be the most useful. Esophagus imaging is simple, reliable and safe.

Keywords: 3D rotational angiography of the heart; Multislice CT scan of heart cavities; Complex atrial and ventricular arrhythmias; Catheter ablation of arrhythmias; Integration of images

Published: November 1, 2011  Show citation