The Clinical Value of Nongated Dual-Source Computed Tomography in Atrial Fibrillation Catheter Ablation.

ABSTRACT

INTRODUCTION: Using a high-pitch dual-source CT (DSCT), we aimed to quantify the amounts of contrast media, radiation doses, and image qualities in patients undergoing pulmonary vein (PV) isolation. METHODS AND RESULTS: The study enrolled 60 patients who were randomly assigned in a 1 1 1 ratio to undergo ECG-gated 64-slice multidetector computed tomography (MDCT; group I, n = 20), ECG-gated 128-DSCT (group II, n = 20), and nongated 128-DSCT (group III, n = 20). The total amount of contrast media was lower in groups II and III compared with group I (I 54.7 ± 5.6, II 26.6 ± 2.7, and III 28.7 ± 6.9 mL, P < 0.001). The CT dose index was lower in groups II and III compared with group I (I 73.1 ± 5.2, II 3.5 ± 0.1, and III 3.7 ± 0.1 mGy, P < 0.001). The dose length product was lower in groups II and III compared with group I (I 1154.8 ± 82.8, II 75.4 ± 2.3, and III 77.2 ± 1.9 mGy × cm, P < 0.001). The total CT effective radiation dose was lower in groups II and III compared with group I (I 16.2 ± 1.2, II 1.1 ± 0.1, and III 1.1 ± 0.1 mSv, P < 0.001). The total CT scan duration was shorter in group III compared with groups I and II (I 30.8 ± 2.2, II 23.4 ± 3.6, and III 16.0 ± 2.4 minutes, P < 0.001). There were no significant differences in quality for integrated electroanatomical mapping (EAM) and parameters associated with PV isolation among the 3 groups. CONCLUSION: Nongated 128-DSCT provides sufficient image quality to allow integrated EAM while exposing the patient to less contrast media, lower radiation doses, and shorter CT scan durations.