Reduced Radiation Exposure Protocol during Computer Tomography of the Left Atrium Prior to Catheter Ablation in Patients with Atrial Fibrillation
Tomasz Jadczyk,
Jiri Wolf,
Martin Pesl,
Filip Soucek,
Frantisek Lehar,
Jiri Jez,
Tomas Kulik,
Bohdan Tyshchenko,
Silvie Belaskova,
Petr Ourednicek,
Guido Caluori,
Miroslav Novak,
Zdenek Starek
Affiliations
Tomasz Jadczyk
Interventional Cardiac Electrophysiology Group, International Clinical Research Center, St. Anne’s University Hospital Brno, 656 91 Brno, Czech Republic
Jiri Wolf
Interventional Cardiac Electrophysiology Group, International Clinical Research Center, St. Anne’s University Hospital Brno, 656 91 Brno, Czech Republic
Martin Pesl
Interventional Cardiac Electrophysiology Group, International Clinical Research Center, St. Anne’s University Hospital Brno, 656 91 Brno, Czech Republic
Filip Soucek
Interventional Cardiac Electrophysiology Group, International Clinical Research Center, St. Anne’s University Hospital Brno, 656 91 Brno, Czech Republic
Frantisek Lehar
Interventional Cardiac Electrophysiology Group, International Clinical Research Center, St. Anne’s University Hospital Brno, 656 91 Brno, Czech Republic
Jiri Jez
Interventional Cardiac Electrophysiology Group, International Clinical Research Center, St. Anne’s University Hospital Brno, 656 91 Brno, Czech Republic
Tomas Kulik
Interventional Cardiac Electrophysiology Group, International Clinical Research Center, St. Anne’s University Hospital Brno, 656 91 Brno, Czech Republic
Bohdan Tyshchenko
Biostatistics, International Clinical Research Center, St. Anne’s University Hospital Brno, 656 91 Brno, Czech Republic
Silvie Belaskova
Biostatistics, International Clinical Research Center, St. Anne’s University Hospital Brno, 656 91 Brno, Czech Republic
Petr Ourednicek
Institute of Mathematics and Statistics, Masaryk University, 611 37 Brno, Czech Republic
Guido Caluori
Interventional Cardiac Electrophysiology Group, International Clinical Research Center, St. Anne’s University Hospital Brno, 656 91 Brno, Czech Republic
Miroslav Novak
1st Department of Internal Medicine—Cardioangiology, St. Anne’s University Hospital Brno, 656 91 Brno, Czech Republic
Zdenek Starek
Interventional Cardiac Electrophysiology Group, International Clinical Research Center, St. Anne’s University Hospital Brno, 656 91 Brno, Czech Republic
(1) Background: Computer tomography (CT) is an imaging modality used in the pre-planning of radiofrequency catheter ablation (RFA) procedure in patients with cardiac arrhythmias. However, it is associated with a considerable ionizing radiation dose for patients. This study aims to develop and validate low-dose CT scanning protocols of the left atrium (LA) for RFA guidance. (2) Methods: 68 patients scheduled for RFA of atrial fibrillation were sequentially assigned to four groups of ECG-gated scanning protocols, based on the set tube current (TC): Group A (n = 20, TC = 33 mAs), Group B (n = 18, TC = 67 mAs), Group C (n = 10, TC = 135 mAs), and control Group D (n = 20, TC = 600 mAs). We used a 256-row multidetector CT with body weight-dependent tube voltage of 80 kVp (90 kg). We evaluated scanning parameters including radiation dose, total scanning procedure time and signal-to-noise ratio (SNR). (3) Results: The average effective radiation dose (ED) was lower in Group A in comparison to Group B, C and D (0.83 (0.76–1.10), 1.55 (1.36–1.67), 2.91 (2.32–2.96) and 9.35 (8.00–10.04) mSv, p < 0.05). The total amount of contrast media was not significantly different between groups. The mean SNR was 6.5 (5.8–7.3), 7.1 (5.7–8.2), 10.8 (10.1–11.3), and 12.2 (9.9–15.7) for Group A, B, C and D, respectively. The comparisons of SNR in group A vs. B and C vs. D were without significant differences. (4) Conclusions: Optimized pre-ablation CT scanning protocols of the LA can reduce an average ED by 88.7%. Three dimensional (3D) models created with the lowest radiation protocol are useful for the integration of electro-anatomic-guided RFA procedures.
