Role of three-dimensional imaging integration in atrial fibrillation ablation

Figure 5 After completing the imaging integration process, pulmonary vein ablation is initiated. The screen of the electroanatomic system shows simultaneously the epicardial (upper) and endocardial (down) aspects of the high resolution computed tomography image of the common os of the left pulmonary veins present in this patient. The green circular icon identifies the multipolar circular mapping catheter, positioned inside the common os to verify its electrical disconnection. The icon of the ablation catheter (white arrows) is also visible, so that this catheter can be manipulated to navigate the three-dimensional computed tomography image with minimal or no use of fluoroscopy. Each red dot marks the site where radiofrequency energy has been applied along the veno-atrial junction of the left pulmonary veins to achieve their electrical disconnection. LIPV: Left inferior pulmonary vein; LSPV: Left superior pulmonary vein; LAA: Left atrial appendage.