Key result
CartoMerge image integration did not significantly improve long-term freedom from atrial fibrillation recurrence compared to non-integrated imaging (69.8% vs 50%), but increased procedure time.
Why the study?
It was unclear whether electroanatomical 3D map and CT/MRI image integration using the CartoMerge system improves efficacy, reduces procedure time, or reduces fluoroscopy usage in patients undergoing pulmonary vein isolation.
Does electroanatomical 3D map and CT/MRI image integration using CartoMerge improve efficacy, reduce procedure time, or reduce fluoroscopy usage in patients undergoing PVI?
Cohort (n=57)
No
Does electroanatomical 3D map and CT/MRI image integration using CartoMerge improve efficacy, reduce procedure time, or reduce fluoroscopy usage in patients undergoing PVI?
Absolute Event Rate: 69.8% vs 50%
p-value: p=0.11793
The use of CartoMerge image integration during PVI did not improve acute or long-term efficacy but significantly increased procedure time and the number of RF applications.
CartoMerge integration was not associated with improved long-term PVI outcomes; leaves open benefit in randomized trials.
Background: Anatomy assessment using Computer Tomography (CT) and Magnetic Resonance (MRI) is performed in patients undergoing pulmonary vein isolation (PVI). The aim of this analysis was to investigate whether electroanatomical 3D map and CT/MRI image integration using the CartoMerge system improves efficacy, reduces procedure time or fluoroscopy usage. Materials and methods: 57 patients undergoing PVI were divided in two groups: "Merge" (n=45 pts) and "non-Merge" (n=14 pts) depending on usage of image integration. PV isolation during procedure (acute PVI), procedure time, fluoroscopy time, number of radio frequency (RF) applications and AF recurrence during follow-up (Merge group: 12-24 months, non-Merge group: 9-18 months) were analyzed. Results: Intra-proceduaral PV was equal in both groups (93%). Long-term efficacy, defined as absence of AF recurrence, was insignificantly higher in the Merge group (69,8% vs 50%, p=0,11793). Procedure time was significantly longer in the Merge group -239,1 (55,5) min. vs 192,4 (44,5). Fluoroscopy time was similar in both groups 29,9 (12,23) vs 24,6 (26,5) min, (p=0,579). Number of RF applications was significantly higher in the Merge group 48,5 (25,2) vs 27,2 (14,9). Conclusions: CartoMerge did not improve the rate of acute PVI, long--term effectivity or fluoroscopy time. In the non-Merge group the procedure time was shorter and the number of applications was significantly smaller.
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Drelich et al. (2019) conducted a cohort in Atrial fibrillation (n=57). CartoMerge image integration vs. Non-integrated 3D CT scan was evaluated on Long-term efficacy (absence of atrial fibrillation recurrence) (p=0.11793). CartoMerge image integration did not significantly improve long-term freedom from atrial fibrillation recurrence compared to non-integrated imaging (69.8% vs 50%), but increased procedure time.
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