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Published in: Journal of Interventional Cardiac Electrophysiology 2/2016

01-08-2016

Respiratory gating algorithm helps to reconstruct more accurate electroanatomical maps during atrial fibrillation ablation performed under spontaneous respiration

Authors: Gábor Széplaki, László Gellér, Emin Evren Özcan, Tamás Tahin, Orsolya Mária Kovács, Nóra Parázs, Júlia Karády, Pál Maurovich-Horvat, Szabolcs Szilágyi, István Osztheimer, Attila Tóth, Béla Merkely

Published in: Journal of Interventional Cardiac Electrophysiology | Issue 2/2016

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Abstract

Purpose

Electroanatomical mapping is a useful tool during the ablation of atrial fibrillation. Respiratory movement might influence the mapping accuracy and merging. This study aims to investigate the effect of respiratory gating on the accuracy of magnetic-field-based electroanatomical mapping under spontaneous respiration.

Methods

Fifty-one consecutive patients (35 male, aged 30–78 years) who underwent left atrial radiofrequency catheter ablation due to atrial fibrillation were included. Electroanatomical mapping was performed with CARTO 3 System under conscious sedation. Respiratory gating was achieved with the AccuResp algorithm (Biosense Webster). Average surface match and maximum distance of the pre-acquired and electroanatomical maps, as well as left atrial volume, were recorded with and without respiratory gating after merging.

Results

The average surface match of the electroanatomical map with the left atrial reconstruction was significantly better with respiratory gating than without using the algorithm (3.81 ± 1.09 vs 4.11 ± 1.61 mm, p = 0.0119). It was not dependent of the rhythm during mapping or the image modality used for left atrial reconstruction. The maximal distance between the two maps did not depend on the use of the algorithm (19.81 ± 6.24 mm for gated and 20.87 ± 7.99 mm for non-gated, p = 0.3161). Left atrial volume of the map was significantly lower when using the respiratory compensation module (106.3 ± 31.6 vs 127.0 ± 36.4 ml, p < 0.0001) and showed a significant correlation with the pre-recorded 3D reconstruction volumes (r = 0.66, p < 0.0001).

Conclusions

The use of the novel respiratory gating algorithm might improve the accuracy of electroanatomical mapping during left atrial ablation under conscious sedation. The possible impact on the effectiveness of the ablation needs to be further evaluated.
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Metadata
Title
Respiratory gating algorithm helps to reconstruct more accurate electroanatomical maps during atrial fibrillation ablation performed under spontaneous respiration
Authors
Gábor Széplaki
László Gellér
Emin Evren Özcan
Tamás Tahin
Orsolya Mária Kovács
Nóra Parázs
Júlia Karády
Pál Maurovich-Horvat
Szabolcs Szilágyi
István Osztheimer
Attila Tóth
Béla Merkely
Publication date
01-08-2016
Publisher
Springer US
Published in
Journal of Interventional Cardiac Electrophysiology / Issue 2/2016
Print ISSN: 1383-875X
Electronic ISSN: 1572-8595
DOI
https://doi.org/10.1007/s10840-016-0105-x

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