Key result
Non-gated MDCT cuts radiation dose ~77% vs ECG-gating with comparable image quality and ablation outcomes.
Why the study?
Does a non-gated MDCT protocol reduce radiation exposure without compromising image quality compared to an ECG-gated protocol in patients prior to catheter ablation of atrial fibrillation?
RCT (n=62)
Blinded (ablation team)
Randomized into two equal groups
No
Does a non-gated MDCT protocol reduce radiation exposure without compromising image quality compared to an ECG-gated protocol in patients prior to catheter ablation of atrial fibrillation?
Non-gated MDCT prior to atrial fibrillation ablation significantly reduces radiation exposure by over four-fold without compromising image quality or procedural metrics compared to ECG-gated MDCT.
Supports non-gated helical MDCT before AF ablation to lower radiation; confirms image quality equivalence in RCT.
BACKGROUND: The role of ECG-gating in left atrium (LA) computed tomography (MDCT) imaging is not precisely defined. METHODS AND RESULTS: 62 patients were randomized according to ECG gating with prospective evaluation of image quality, Volume CT Dose Index, Dose Length Product, Effective Dose and registration error between anatomical map and MDCT. We found significant difference in all radiation variables, but not in visual quality, registration error, CA duration, CA fluoroscopy time and CA fluoroscopy dose. CONCLUSION: Helical non-gated MDCT achieved a radiation dose more than four times lower with comparable image quality and course of ablation compared to ECG-gated protocol.
No takes yet. Share an insight, caveat, or question.
Tüdös et al. (2018) conducted an RCT in Paroxysmal atrial fibrillation (n=62). Helical non-gated MDCT vs. Retrospective ECG-gated MDCT was evaluated on Effective radiation dose (mSv) (p=<0.0001). Helical non-gated MDCT achieved a significantly lower mean effective radiation dose (5.58 mSv vs 24.46 mSv, p<0.0001) with comparable image quality and ablation outcomes compared to the ECG-gated protocol.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: