Novel uses of Imaging in AF Ablation
Sandeep Prabhu, Alex J.A. McLellan, Alex Voskoboinik and Peter M. Kistler
Affiliation: Baker IDI Heart and Diabetes Institute, 75 Commercial Road, Melbourne, Victoria, Australia 3004.
AF represents a significant burden for patients, clinicians and health policy makers alike. Catheter based AF
ablation is gaining an increasing role as an effective treatment for AF, capable of reducing or even eliminating the disease.
AF ablation relies on isolation of arrhthymogenic triggers and alteration of the atrial substrate by carefully targeted atrial
ablation, using a minimally invasive approach. Pre-procedural CT, MRI and echocardiography are crucial in evaluating
the degree of atrial remodelling which may impact of procedural success, as well as identification of crucial cardiac and
non-cardiac adjacent structures, and LAA thrombus. Electro-anatomical mapping is the cornerstone of intra-procedural
imaging, which can be optimised by integration with pre-procedural imaging. Other technologies such as 3D rotational
angiograpy, intracardiac echocardiography and real-time MRI are improving the safety and efficacy of the procedure.
Post-procedural MRI and CT can effectively monitor and evaluate procedural complications and atrial structure and remodelling.
Recent patents demonstrate the wealth of technological advancements in AF ablation and are evident in multiple
aspects of the procedure.
Keywords: Ablation, atrial fibrillation, imaging, CARTO, CT, 3D rotational angiography, Electroanatomical mapping, Ensite
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