Key result
Three-dimensional atriography provided comparable anatomical accuracy to cardiac computed tomography with significantly lower radiation dose (2.2 vs 20.4 mSv) and less time (13 vs 46 minutes; P<0.05).
Why the study?
Does intraoperative 3D-ATG provide comparable anatomical accuracy with lower radiation and cost compared to preoperative CCT in patients undergoing AF ablation?
Observational (n=70)
Does intraoperative 3D-ATG provide comparable anatomical accuracy with lower radiation and cost compared to preoperative CCT in patients undergoing AF ablation?
p-value: p=<0.05
Intraprocedural 3D-ATG provides comparable anatomical accuracy to preoperative CCT for AF ablation, but with significantly lower radiation exposure, time, and cost.
May support lower-radiation 3D atriography in AF ablation; leaves open randomized confirmation before practice change.
BACKGROUND: Atrial fibrillation (AF) ablation is facilitated by anatomical visualization of the left atrium (LA) and the pulmonary veins (PVs). The purpose of this study was to compare accuracy, radiation exposure, and costs between three-dimensional atriography (3D-ATG) and cardiac computed tomography (CCT). METHODS: Seventy patients with an indication for AF ablation were included. Contrast-enhanced CCT was performed preoperatively for all patients. In addition, intraoperative 3D-ATG was performed with contrast medium injection either indirectly into the pulmonary arteries during a breath-hold (Ind.-RTA, n = 25) or directly into the LA, during adenosine-induced asystole (Ad.-RTA, n = 23), or rapid ventricular pacing (VP-RTA, n = 22). We evaluated vertical ostial PV diameters and LA volume, time needed to perform, radiation exposure, and procedural cost for each imaging method. RESULTS: The correlation coefficient between 3D-ATG and CCT for the ostial PV diameters was r = 0.83 for Ind.-RTA, 0.91 for Ad.-RTA, and 0.88 for the VP-RTA method (P > 0.05). The volume correlations were r = 0.87 for Ind.-RTA, 0.82 for Ad.-RTA, and 0.8 for VP-RTA (P > 0.05). Time to perform was 13 ± 5 minutes for ATG and 46 ± 9 minutes for CCT (P < 0.05). Effective radiation dose was 2.2 ± 0.2 mSv for ATG and 20.4 ± 7.4 mSv for CCT (P < 0.05). The procedural cost was estimated at 91-95 € for ATG and at 126-151 € for CCT. CONCLUSIONS: 3D-ATG is an intraprocedural imaging modality that provides anatomical accuracy comparable to that of CCT with significantly lower radiation dose, in less time and at less financial expense (PACE 2011; 34:315-322).
No takes yet. Share an insight, caveat, or question.
Kriatselis et al. (2010) conducted an observational in Atrial fibrillation (n=70). Three-dimensional atriography (3D-ATG) vs. Cardiac computed tomography (CCT) was evaluated on Accuracy (ostial PV diameters and LA volume), time to perform, radiation exposure, and procedural cost (p=<0.05). Three-dimensional atriography provided comparable anatomical accuracy to cardiac computed tomography with significantly lower radiation dose (2.2 vs 20.4 mSv) and less time (13 vs 46 minutes; P<0.05).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: