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Intraprocedural imaging of left atrial and pulmonary vein anatomy for atrial fibrillation ablation

Image guidance facilitates catheter-based ablation of atrial fibrillation. Preprocedural magnetic resonance (MR) or computed tomographic (CT) imaging of the left atrium (LA) and pulmonary veins (PV) has been used to derive essential information about cardiac anatomy, however, significant changes in morphology can occur between preprocedural imaging and the actual intervention. The two procedures can be separated in time by days or even weeks, during which changes in volume status and other physiological factors can occur. We present and validate an intraprocedural imaging method based on contrast-enhanced 3D rotational X-ray angiography (3DRA) which allows for near-real-time 3D characterization of LA/PV anatomy with good accuracy and reproducibility.