Abstract 2243: Real-Time Computed Tomography (RT-CT) for Guidance of Catheter Navigation, Transseptal Puncture and Anatomically Targeted Radiofrequency Ablation

• DOI: 10.1161/circ.116.suppl_16.ii_489
• Publication Date: 2021-07-03T01:30:53Z
• Authors: Timm Dickfeld; Martin Engelhardt; Katrina Read; Christopher Kocher; Jagan Akella; Anthony Johnson; Robert Peters; Magdi Saba; Stephen Shorosfsky; Thorsten Fleiter
• Keywords: 03 medical and health sciences; 0302 clinical medicine

Background: Recent ablation strategies for complex arrhythmias such as atrial fibrillation or ischemic ventricular tachycardia are increasingly based on anatomic considerations. While fluoroscopy and 3D-mapping systems widely used to guide these ablations, they limited by poor soft tissue visualization the lack of real-time data. Therefore, this study sought evaluate if computed tomography (RT-CT) could overcome limitations catheter navigation, transseptal puncture anatomically targeted ablation. Methods: Catheter guidance was assessed in 5 swine (40kg) using a 40-slice RT-CT. First, right/left heart catheterization performed from femoral vein artery with goal access all cardiac chambers great vessels. Second, attempted ablations at pre-specified locations left lateral wall. Third, pulmonary (PV) orifice repeat right wall were created assess accuracy precision, respectively. Fourth, creation straight four-point line attempted. Necropsy possible complications compare location sites CT images. Results: navigation safely ventricle. Misguided catheters renal vein, jugular carotid correctly identified removed. Transseptal Brocken-brough needle successfully confirmed Accuracy PV range 1–3mm. Repeat revealed precision 2–3mm. Maximum deviation 4-point 2.8mm. No seen necropsy. Conclusions: (in four chambers) well can be guided exclusively Anatomically good under guidance. This suggests role RT-CT procedures.