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Does merged three-dimensional mapping improve contact force and long-term procedure outcome in atrial fibrillation ablation? (MICRO-AF study): a prospective randomized controlled study

Title
Does merged three-dimensional mapping improve contact force and long-term procedure outcome in atrial fibrillation ablation? (MICRO-AF study): a prospective randomized controlled study
Authors
Shin D.G.Roh S.Y.Ahn J.Park S.W.Kim D.-H.Han S.-J.Lim H.E.
Ewha Authors
김동혁
SCOPUS Author ID
김동혁scopus
Issue Date
2021
Journal Title
International Journal of Cardiovascular Imaging
ISSN
1569-5794JCR Link
Citation
International Journal of Cardiovascular Imaging vol. 37, no. 12, pp. 3431 - 3438
Keywords
Atrial fibrillationCatheter ablationHigh density mappingImage integration
Publisher
Springer Science and Business Media B.V.
Indexed
SCIE; SCOPUS scopus
Document Type
Article
Abstract
Integration of electroanatomical map (EAM) with preacquired three-dimensional (3D) cardiac images provides detailed appreciation of the complex anatomy of the left atrium (LA) and pulmonary vein (PV). High-density (HD) multi-electrode mapping catheters have enabled creating more accurate EAM reflecting real-time volume-rendered LA–PV geometry during atrial fibrillation (AF) ablation. However, no study has compared the outcomes of AF ablation using HD–EAM versus 3D-merged map. We aimed to investigate the procedural and clinical outcomes of AF ablation with HD–EAM (HD–EAM group) versus 3D-merged map (Merge group).One hundred patients (59.5 ± 11.5 years, 53% with paroxysmal AF [PAF]) were randomly assigned (1:1) to HD–EAM or Merged group. HD multi-electrode mapping and contact force (CF)-sensing catheters were used to create virtual LA–PV chamber and to perform wide antral circumferential ablation (WACA), respectively. The two groups showed no significant differences in baseline characteristics and procedural data including ablation time, fluoroscopy time, LA voltage, and CF. PV isolation with a single WACA line was achieved in 21 (42%) and 27 (54%) patients in the Merge and HD-EAM groups, respectively (P = NS). CF was significantly lower in lesions with gap than lesions without gap after a single WACA (7.3 ± 7.3 g vs. 16.0 ± 8.3, respectively, P < 0.001). During the 12-month follow-up, no significant difference in AF recurrence was observed between two groups, irrespective of AF type. In multivariate analysis, non-PAF was an independent risk factor for AF recurrence. Integration of 3D cardiac imaging did not improve procedural and clinical outcomes. HD–EAM provides an accurate real-time LA geometry. © 2021, The Author(s), under exclusive licence to Springer Nature B.V.
DOI
10.1007/s10554-021-02335-8
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의료원 > 의료원 > Journal papers
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