Utility of Rotate 3D Angiography with CARTO 3 Guided Pulmonary Vein Isolation

CMR-guided targeting of gaps after initial pulmonary vein isolation.

SEE PAGE 653 P ulmonary vein (PV) isolation has become an established treatment for symptomatic drugrefractory atrial fibrillation (AF). However, the efficacy of AF ablation is suboptimal, with a majority of failures resulting from discontinuities in circumferential ablation sets for PV isolation. The presence of PV entrance and exit conduction block serves as a surrogate of complete circumfere...

Determinants of Acute and Late Pulmonary Vein Reconnection in Contact Force–Guided Pulmonary Vein Isolation

Catheter-based pulmonary vein isolation (PVI) is associated with a single procedure freedom from atrial fibrillation (AF) in ≈70% of patients with paroxysmal AF. Lack of durability of PVI, a major determinant of AF recurrence, is evidenced by acute PV reconnection at the time of the procedure and late pulmonary vein reconnection (PVR) during followup. The use of contact force (CF)–sensing cathe...

Pulmonary vein wedge angiography.

Complications of pulmonary vein angiography.

A severe complication of pulmonary vein angiography.

A pulmonary vein angiogram was performed using a pressure injection with the tip of an end and side hole catheter in a near-wedge position; extravasation of contrast material into a bronchus occurred, causing severe bronchoconstriction. It may be possible to avoid this complication by the use of an end hole balloon catheter in the wedge position, slow flow rates of contrast material, and low pr...