Editorial
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World J Cardiol. Aug 26, 2010; 2(8): 215-222
Published online Aug 26, 2010. doi: 10.4330/wjc.v2.i8.215
Role of three-dimensional imaging integration in atrial fibrillation ablation
Roberto De Ponti, Raffaella Marazzi, Domenico Lumia, Giuseppe Picciolo, Roberto Biddau, Carlo Fugazzola, Jorge A Salerno-Uriarte
Roberto De Ponti, Raffaella Marazzi, Giuseppe Picciolo, Roberto Biddau, Jorge A Salerno-Uriarte, Department of Heart, Brain and Vessels, Ospedale di Circolo e Fondazione Macchi, University of Insubria, IT-21100 Varese, Italy
Domenico Lumia, Carlo Fugazzola, Department of Radiology, Ospedale di Circolo e Fondazione Macchi, University of Insubria, IT-21100 Varese, Italy
Author contributions: All authors equally contributed to this paper.
Correspondence to: Roberto De Ponti, MD, FHRS, Department of Heart, Brain and Vessels, Ospedale di Circolo e Fondazione Macchi, University of Insubria, Viale Borri, 57, IT-21100 Varese, Italy. rdeponti@alice.it
Telephone: +39-332-278934 Fax: +39-332-393644
Received: June 17, 2010
Revised: July 13, 2010
Accepted: July 20, 2010
Published online: August 26, 2010
Abstract

Atrial fibrillation is the most common arrhythmia and in symptomatic patients with a drug-refractory form, catheter ablation aimed at electrically disconnecting the pulmonary veins (PVs) has proved more effective than use of antiarrhythmic drugs in maintaining sinus rhythm during follow-up. On the other hand, this ablation procedure is complex, requires specific training and adequate clinical experience. A main challenge is represented by the need for accurate sequential positioning of the ablation catheter around each veno-atrial junction to deliver point-by-point radiofrequency energy applications in order to achieve complete and persistent electrical disconnection of the PVs. Imaging integration is a new technology that enables guidance during this procedure by showing a three-dimensional, pre-acquired computed tomography or magnetic resonance image and the relative real-time position of the ablation catheter on the screen of the electroanatomic system. Reports in the literature suggest that imaging integration provides accurate visual information with improvement in the procedure parameters and/or clinical outcomes of the procedure.

Keywords: Catheter ablation; Atrial fibrillation; Electroanatomic mapping; Multislice computed tomography; Magnetic resonance imaging