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The impact of ECG synchronization during acquisition of left-atrium computed tomography model on radiation dose and arrhythmia recurrence rate after catheter ablation of atrial fibrillation - a prospective, randomized study
Skala T., Tudos Z., Homola M., Moravec O., Kocher M., Cerna M., Ctvrtlik F., Odstrcil F., Langova K., Klementova O., Taborsky M.
Language English Country Slovakia
Document type Randomized Controlled Trial
- MeSH
- Radiation Dosage MeSH
- Adult MeSH
- Electrocardiography MeSH
- Atrial Fibrillation surgery MeSH
- Risk Assessment MeSH
- Catheter Ablation * methods MeSH
- Humans MeSH
- Multidetector Computed Tomography methods MeSH
- Prospective Studies MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Publication type
- Randomized Controlled Trial MeSH
BACKGROUND: The impact of ECG gating during computed tomography (CT) acquisition of left atrium (LA) model on radiation dose, image quality and ablation event-free survival rate after catheter ablation (CA) of atrial fi brillation (AF) is not well defi ned. METHODS: Sixty-two patients with paroxysmal atrial fi brillation were randomized for two types of LA CT (with vs without ECG gating) before CA. Pulmonary veins isolation was performed in all patients. Patients were followed for 12 months after CA. RESULTS: There was no difference between the groups in CA length (131.61±32.57 vs 119.84±33.18 min; p=0.108), CA fl uoroscopy time (4.48±2.19 vs 3.89±1.83 min; p=0.251), CA fl uoroscopy dose (3.99±2.79 vs 3.91 vs2.91 Gy*cm2; p=0.735), visual data quality (1.77±0.88 vs 2.0±0.63; p=0.102) and registration error (2.42±0.72 vs 2.43±0.46 mm; p=0.612). We found a significant difference in CT Dose index (89.55±5.99 vs 19.19±4.33 mGy; p<0.0001) and Dose Length product (1438.87±147.75 vs 328.21±73.83 mGy*cm; p<0.0001). Twelve months after CA, 25 of 31 patients in the gated group and 24 of 31 patients in the non-gated group were free of AF (80.65 vs 77.42 %; p=0.838). CONCLUSION: ECG gating of computed tomography of LA before AF ablation burdens patients with a four times higher radiation dose while improving neither the quality of CT model or fusion of CT with the electroana-tomic map. As a result, it has no significant impact on arrhythmia recurrence rate after ablation (Tab. 3, Fig. 3, Ref. 25).
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Literatura
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- $a Skála, Tomáš $7 xx0137536 $u Department of Internal Medicine I - Cardiology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Czech Republic
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- $a The impact of ECG synchronization during acquisition of left-atrium computed tomography model on radiation dose and arrhythmia recurrence rate after catheter ablation of atrial fibrillation - a prospective, randomized study / $c Skala T., Tudos Z., Homola M., Moravec O., Kocher M., Cerna M., Ctvrtlik F., Odstrcil F., Langova K., Klementova O., Taborsky M.
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- $a BACKGROUND: The impact of ECG gating during computed tomography (CT) acquisition of left atrium (LA) model on radiation dose, image quality and ablation event-free survival rate after catheter ablation (CA) of atrial fi brillation (AF) is not well defi ned. METHODS: Sixty-two patients with paroxysmal atrial fi brillation were randomized for two types of LA CT (with vs without ECG gating) before CA. Pulmonary veins isolation was performed in all patients. Patients were followed for 12 months after CA. RESULTS: There was no difference between the groups in CA length (131.61±32.57 vs 119.84±33.18 min; p=0.108), CA fl uoroscopy time (4.48±2.19 vs 3.89±1.83 min; p=0.251), CA fl uoroscopy dose (3.99±2.79 vs 3.91 vs2.91 Gy*cm2; p=0.735), visual data quality (1.77±0.88 vs 2.0±0.63; p=0.102) and registration error (2.42±0.72 vs 2.43±0.46 mm; p=0.612). We found a significant difference in CT Dose index (89.55±5.99 vs 19.19±4.33 mGy; p<0.0001) and Dose Length product (1438.87±147.75 vs 328.21±73.83 mGy*cm; p<0.0001). Twelve months after CA, 25 of 31 patients in the gated group and 24 of 31 patients in the non-gated group were free of AF (80.65 vs 77.42 %; p=0.838). CONCLUSION: ECG gating of computed tomography of LA before AF ablation burdens patients with a four times higher radiation dose while improving neither the quality of CT model or fusion of CT with the electroana-tomic map. As a result, it has no significant impact on arrhythmia recurrence rate after ablation (Tab. 3, Fig. 3, Ref. 25).
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